Enterobacteriaceae Producing β-lactamase Resistance and Caused by Drug-resistant Infectious Disease Research
|Keywords||Enterobacteriaceae α - lactamase Resistance blaTEM-1D -type resistance gene Infectious Diseases|
Objective: To study the Dali Enterobacteriaceae producing β-lactam enzyme bacterial resistance and its due to the prevalence of infectious diseases and blαTEM-lD-type resistance gene, guiding the clinical application of antibiotics. Methods: (1) the qualitative detection of Enterobacteriaceae producing β-lactamase resistant species collected, identified and enzyme production strains: from the Affiliated Hospital of Dali University, Dali Prefecture Hospital, First Hospital of Dali City selected clinical isolates of intestinal The bacilli Division produced β-lactamase enzyme resistant bacteria (at least 1 β-lactam antibiotic resistance), automated microbial identification system (VITEK) identification to species. Cephalosporin whistle thiophene filter paper method (nitrocefin test) per plant bacteria to detect whether strains producing β-lactamase. Plant bacteria test later transferred species in the 2ml EP filled with sheep blood tube placed in -70 ℃ refrigerator spare 16 to 20 hours after incubation. (2) antimicrobial susceptibility testing: MIC methods (microdilution method) resistant selection of eight kinds of beta-lactam antibiotics susceptibility testing, statistical multi-drug resistance rates of various antibiotics Ho the main kinds strains. (3) blαTEM-lD resistance gene detection (PCR method): extraction of the plasmid DNA of the resistant strains, good design primers to amplify the target DNA, using agarose gel electrophoresis, using Mark signifies Measure the size of the amplicons (bp length), standard PCR amplification and then agarose gel electrophoresis analysis of the size of the amplicons to detect whether containing blαTEM-lD-resistant gene. The ratio of the resistance gene and statistics blαTEM-lD. (4) due to the relationship of infectious diseases: clinical medical records retrospectively analyzed specimens source of bacteria with clinical disease. Results and conclusions: (1) in this group test Enterobacteriaceae Escherichia 64 (Escherichia coli), Klebsiella 41 (lung grams of 39 acid-producing gram 2) Enterobacter 4 of 16 (agglomerate intestinal gas intestinal a), 8 (liquefied sand seven Serratia, clayey sand 1), Salmonella 3 (paratyphi 2 strains of Salmonella typhi 1), two Shigella (Shigella bacteria 2), Proteus 1 (a Proteus mirabilis), Morgan genus 1 (a Morganella morganii) Yersinia, Yersinia genus 1 (colon, 1). 9 genus and 14 strains of 137. Lack of Citrobacter spp specimens. Escherichia coli isolation rate is the highest, followed by Klebsiella. 52 Affiliated Hospital of Dali University, Dali State Hospital 33, First Hospital of Dali City 52. The reaction of the β-lactamase enzyme assay showed a positive (red) are producing strains. (2) The test multidrug resistant serious resistant 88.7% more than double. Descending order as follows: 19.0% of triple-resistant, heavy resistance by 18.2%, 14.6% five heavy resistance, the six heavy resistance by 12.4%, 11.7% four heavy resistance, the seven heavy resistance by 11.7%, eight heavy resistance 1, accounting for 0.7%. Triple-drug resistance is the most serious, eight heavy resistance at least. Various beta-lactam antibiotic resistance rate, ampicillin and cefuroxime resistance rates are higher in the region should not be used. Thailand can lower resistance rates in the region are still valid. Other five kinds of different levels of resistance, making susceptibility testing selective use is still valid. (3) in this group test blaTEM-1D-type resistance gene-positive 62, the ratio was 45.3% (62/137). Escherichia coli 31, the ratio was 22.7% (31/137); 18 Klebsiella pneumoniae, the ratio was 13.2% (18/137). Other less. blαTEM-lD-type resistance gene in the region's hospitals horizontal transmission and vertical transmission in hospitals. (4) The test specimens wide variety of sources, sputum, urine, feces, blood, pus, body secretions, bile, ascites, pleural fluid, cerebrospinal fluid, venous catheters, throat swab, etc.. Source of specimen sputum (43.1%), urine (20.4%), mainly cause breathing (51.8%), urinary tract (20.4%) infections, pathogens, mainly Escherichia coli (46.7%), Cray Bo bacteria (29.9%). Cause blood infections Escherichia coli infections of the central nervous system Klebsiella pneumoniae, Escherichia coli trauma and surgical infection. Respiratory infections Klebsiella and E. coli. Gastrointestinal infection inflammation Klebsiella, Shigella, Escherichia coli and Serratia. Escherichia coli urinary tract infection. The test Enterobacteriaceae closely related to the clinical departments, but mainly Respiratory Medicine, ICU, Urology, General Surgery. Respiratory Medicine, Klebsiella, Escherichia coli; Urology Escherichia coli; ICU Escherichia coli, Klebsiella, the main reason is the Section patients in critical condition, the body immunocompromised, using a breathing machine, and long-term large-scale use of antibiotics cause infection resulting in flora. General Surgery, Escherichia coli, mainly purulent infection. Another feature of the test is: Proteus, Morgan bacilli often lead to urinary tract infections, colon, Yersinia pestis, the digestive tract infection pathogens, this set of experiments they found Proteus mirabilis, Morganella morganii bacteria, colon yeah Mickelson bacteria each one caused by respiratory infections, and less common. 2. Klebsiella is a common cause of respiratory tract, urinary tract and wound infections, and Serratia common cause of pneumonia, urinary tract infections, sepsis and postoperative infections, the experiments also found two Klebsiella, Serratia 1 strains cause gastrointestinal infection, a rare condition. Due to the small number of cases, it is not for further analysis.