The Antimicrobial Susceptiblity Of ESBLs Producing Escherichia Coli In The Fourth Quarter Of 2019 In Mudanjiang Area Of Heilongjiang Province And The Role Of Proton Pump In The Resistant Mechanism

Objective: To understand the distribution and drug resistance of Escherichia coli produced by extended-spectrum β-lactamase(ESBLs)in Mudanjiang area,Heilongjiang Province,to study and analyze its drug resistance mechanism,and to apply antibacterial drugs in a reasonable and effective clinical setting Medicine and nosocomial infection control provide experimental basis.Methods: Collect Escherichia coli isolated in the fourth quarter of 2019 from three hospitals in Mudanjiang area,Heilongjiang Province,and conduct strain identification and ESBLs detection.The drug susceptibility test was performed by the paper diffusion method,and the drug resistance model was grouped according to the results.PCR amplification of the experimental strains acra and acrb gene fragments and sequencing analysis.Micro broth dilution method was used to determine the changes in the minimum inhibitory concentration(MIC)of the three antibiotics,cefotaxime,ciprofloxacin and gentamicin,before and after the addition of the proton pump inhibitor CCCP.Results: A total of 133 strains of Escherichia coli were collected,and the detection rate of ESBLs production was 45.1%(60/133).The133 strains of Escherichia coli have the highest resistance rate to quinolones,and the resistance mode is dominated by double-drug resistance and multi-drug resistance.PCR results showed that 87 strains of Escherichia coli carried the acra gene,and 84 strains of Escherichia coli carried the acrb gene.Compared with non-ESBLs-producing Escherichia coli,the positive rates of acra and acrb were significantly different(P<0.01).The positive rates of acra and acrb genes in the multi-drug resistance group were significantly different from those in the fully sensitive group(P<0.01).The MIC values of cefotaxime,ciprofloxacin and gentamicin were significantly different for the ESBLs-producing multi-drug resistant bacteria before and after adding CCCP(P<0.05).Conclusion: ESBLs-producing Escherichia coli strains are generally resistant to clinically used antibiotics in Mudanjiang area,and there is a phenomenon of multi-drug resistance.The detection rate of the efflux pump genes acra and acrb in the ESBLs-producing multi-drug resistant Escherichia coli in this region is relatively high,and the multi-drug resistant Escherichia coli has both active efflux and ESBLs-producing resistance mechanisms.The proton pump inhibitor CCCP can reduce to varying degrees the MIC values of cefotaxime,ciprofloxacin and gentamicin for the ESBLs-producing multi-drug resistant Escherichia coli in the region,and CCCP can reverse the ESBLs-producing Escherichia coli which are resistant to ciprofloxacin and gentamicin.