Study On ESBLs Genotype And Antimicrobial Resistance Of ESBLs-Producing Escherichia Coli And Klebsiell Pneumoniae From Clinical Sample In Lanzhou

Objective:To study clinical isolated bacteria distribution, drug resistance characteristics and the separation rate of ESBLs gene classification of E.coli and K.pneumoniae.Understanding of the ESBLs genotypes, provide the basis for rational selection of antimicrobial agents in a tertiary hopital of lanzhou in 2013. Methods: A tertiary hopital in lanzhou region between January 2013 and December 2013, all the strains isolated from clinical as the research object, using the disc diffusion method(K- B) susceptibility test was carried out on the separation strains in 2013, according to CLSI standard for determining susceptibility results, using WHONET5.6 software is analyzed with the result of resistance; With collaborative disc diffusion method for E.coli and K.pneumoniae to produce ESBL strain screening; Selected from 40 strains of E.coli, 20 strains of K.pneumoniae a bacteria, application of PCR technology, gel electrophoresis amplification and detection of SHV, TEM and CTX-m gene carrying case. Results: In 2013,a tertiary hopital in lanzhou, a total of 3160 strains bacteria isolated(not repeat strains), includes gram-negative bacillus(74.4%). E. coli and K.pneumonia producing ESBLs strains bacteria detection rate was 59.9%(292/870), 26.4%(111/536). Carbapenem drug drugs remain the gram-negative bacilli of Enterobacteriaceae most sensitive drugs. Producing ESBLs E. coli in TEM was 5.0%(2/40), SHV was 42.5%(17/40), CTX- M was 85.0%(34/40); TEM in producing ESBLs K.pneumonia was 20.0%(4/20), SHV was 75.0%(15/20), CTX-M was 75.0%(15/20).Conclusion: the Enterobacteriaceae bacteria were the main clinical isolated pathogenic bacteria, E.coli and K.pneumonia bacteria is the most common Enterobacteriaceae pathogen. ESBLs producing bacteria E.coli and K.pneumonia is the main resistance mechanism, and producing ESBLs of E.coli and K.pneumonia bacteria separation rate increased year by year. Producing ESBLs is E.coli and K.pneumonia bacteria for commonly used beta lactam, aminoglycoside, quinolone antibacterial drug resistant rate than producing ESBLs strains of high resistance to common. E.coli and K.pneumonia bacteria producing ESBLs genotypes to CTX- M type, followed by SHV type, type TEM detection rate. E.coli and K.pneumonia bacteria producing ESBLs genotypes of CTX- M type, SHV type and TEM type single detection rate is low, Most of the strains, containing two or more than two kinds of coexistence of a variety of genotypes in the same strain of bacteria, mediating the drug resistance of bacteria produce complex phenotypes. CTX- M type alone or with SHV, TEM type ESBLs of cefotaxime resistance than his organism and ammonia cephalosporin resistant rate is high. Experimental strains of bacteria from hospital-acquired producing ESBLs is e. coli and klebsiella pneumonia bacteria, producing ESBLs strains of widespread, much attention should be paid, and strengthen the bacterial drug resistance testing, reasonable standard use of antibiotics, prevent the happening of the hospital are popular..