目的：了解乌苏市产超广谱β-内酰胺酶（ESBLs）大肠埃希菌和肺炎克雷伯菌的耐药状况及 TEM、SHV 基因型的流行情况。方法收集乌苏市两所医院2011年7月至2013年6月分离的大肠埃希菌和肺炎克雷伯菌，采用纸片扩散法（K-B 法）进行药敏试验，并按照 CLSI 推荐的方法进行 ESBLs 初步筛选和表型确证试验，同时提取产 ESBLs 菌株的 DNA，采用 PCR 和电泳方法检测 TEM、SHV 基因。结果共收集大肠埃希菌221株，肺炎克雷伯153株。其中产 ESBLs 菌株分别为37株和43株，肺炎克雷伯菌 ESBLs 检出率高于大肠埃希菌（χ2＝6．942，P ＜0．01）。两种菌的耐药情况较为相似，其中产 ESBLs 菌株对β-内酰胺类抗菌药物的耐药率明显高于非产酶株，大多在90％以上；对青霉素类和一、二代头孢类的耐药率接近100％；对庆大霉素和环丙沙星的耐药率也在50％以上；而对碳青霉烯类药物的耐药率较低，均不到5％。产 ESBLs 大肠埃希菌 TEM、SHV 基因的检出率分别为72．9％、54．0％，肺炎克雷伯菌分别为81．4％、65．1％，检出率基本一致（P ＞0．05）。结论乌苏市大肠埃希菌和肺炎克雷伯菌 ESBLs 检出率较高，耐药形势严峻，TEM、SHV 是 ESBLs 重要的基因型。%Objective To understand the drug resistance status of extended-spectrum beta-lactamase(ESBLs)-producing Esche-richia coli (E.coli)and Klebsiella pneumonia (KPN ),and the prevalence situation of TEM and SHV genotype in Wusu city.Meth-ods E.coli and KPN isolated in two hospitals of Wusu city from July 2011 to June 2013 were collected and the drug sensitivity test was performed by the disk diffusion method (K-B method),the ESBLs preliminary screening and the phenotypic confirmatory test were carried according to the guideline of CLSI,and at the same time DNA of ESBLs producing strains was extracted and the TEM and SHV genes among them were tested by PCR and the electrophoresis method.Results Totally 221 strains of E.coli and 153 strains of KPN were collected,among them ESBLs producing strains were 37 strains and 43 strains respectively,and the detec-tion rate of ESBLs in KPN was higher than that in E.coli(χ2 =6.942,P <0.01).The drug resistance of two kinds of bacteria were similar,the resistance rate of ESBLs producing strains to beta lactam antibacterial drugs was obviously higher than that in non-en-zyme producing strains,which was mostly more than 90%;the resistance rate to penicillin and the first or second generation cepha-losporins was almost 100%;which to gentamicin and ciprofloxacin was above 50%;while which to carbapenem was lower,less than 5%.The detection rates of TEM and SHV genes were 72.9% and 54% in ESBLs producing E.coli and 81.4% and 65.1% in KPN respectively,the detection rates were basically consistent without statistically significant differences between them (P >0.05).Conclusion The detection rate of ESBLs producing E.coli and KPN in Wusu city is higher,the drug resistance situation is severe,and TEM,SHV are the important genotypes of ESBLs.
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