| OBJECTIVETo investigate the antibacterial resistance of clinical common gram-negative bacterium, the distribution of multidrug-resistant bacterium, to study theβ-lactamase gene TEM, SHV, CTX-M as well as disinfectant resistant gene qacE△1-sul1 in clinical multi-drug resistant Gram-negative bacterium.METHODS(1) The Kirby-bauer (KB) method was used to study the antibacterial resistance in a total of 1374 strains Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii isolated in Air Force General Hospital from 2008 to 2009.(2) Polymerase chain reaction (PCR) was used to detect three kinds ofβ-lactamase genes TEM , SHV, and CTX-M and disinfectant resistance gene qacE△1-sul1 in 155 common clinical drug-resistant bacteria including ESBLs producing strains of Escherichia coli, Klebsiella pneumoniae, Multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii.RESULT(1) 1374 aims pathogens were isolated from a variety of samples among hospitalized patients during two years. 384 strains of Escherichia coli, 263 of strains Klebsiella pneumoniae had relatively similar antibacterial resistance rates to ampicillin , the antibacterial resistance rates were more than 90%; Both were sensitive to the enzyme inhibitor antibacterials and the carbapenem antimicrobials such as imipenem and meropenem; To the other antibacterials the resistance of Escherichia coli were significantly higher than Klebsiella pneumoniae. 530 of strains Pseudomonas aeruginosa were more sensitive to those containing enzyme inhibitors antibacterials, amikacin, ceftazidime and cefepime, the resistance rates were less than 30%; Strong resistance were showed to cefoperazone, levofloxacin, and imipenem, the resistance rates were more than 40%. 197 strains of Acinetobacter bauman were more sensitive to carbapenem antibacterials and amikacin, the resistance rates were less than 30%. For carbapenem antibiotics, the resistance rates were less than 20%. For three generations, and four generations of Cephalosporin antibacterials were less sensitive. 230 strains of multi-drug resistance bacteria included producing ESBLs Escherichia coli, producing ESBLs Klebsiella pneumoniae multi-drug resistant Pseudomonas aeruginosa and multi-drug resistant Acinetobacter baumannii, the total detection rate was 16.7%. These were mainly distributed in total eight departments including neurosurgery, intensive care unit, endocrine department and so on.(2) Among 50 strains producing ESBLs Escherichia coli, there were 41 strains TEM gene-positive (82.0%), 7 strains SHV gene-positive (14.0%) and 16 strains CTX-M gene-positive (32.0%). 21 strains had two or more positive genotypes at the same time. Among 27 strains producing ESBLs Klebsiella pneumoniae, TEM gene were positive in 21 strains (77.8%), SHV gene were positive in 24 strains (88.9%), CTX-M gene were positive in 3 strains (11.1%). 16 strains had more than two genotypes at the same time. The expression of TEM gene was found in 37 of 50 strains of multi-drug resistant Pseudomonas aeruginosa and the positive rate was 74.0%. SHV and CTX-M gene were not detected. The TEM gene was found in 25 of 28 strains of multi-drug resistant Acinetobacter baumannii and the positive rate was 89.3%. 2 strains had SHV gene (7.1%) but the CTX-M genes were not detected. In the four kinds of bacteria disinfectant-resistant gene qacE△1-sul1 were detected respectively in 37,24,46 and 28 strains, with detection rate of 74.0%, 88.9%, 92.0 and 100%. The total detection rate was 87.1%.CONCLUSIONSTo Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii, the carbapenem antibacterials as well as the complex antibacterials containingβ-lactamases enzyme inhibitors were more sensitive. For Pseudomonas aeruginosa the enzyme inhibitors antibacterials were sensitive, but Pseudomonas aeruginosa had the strong resistance to imipenem. Multi-drug resistant bacteria Isolated mainly in the departments which had old age patients, interventional therapy, and patients with severe underlying disease. In the four kinds of multi-drug resistant Gram-negative bacteria, theβ-lactamase gene had high detection rates, indicating as the broad-spectrum antimicrobial generally used in clinical could lead to the phenomenon of multi-drug resistance bacteria growing. The distribution of bacteria and drug resistance should be regular surveillance in order to guide clinical rational use of antibacterial, control infection and reduce the emergence of resistant. Disinfectant-resistant gene qacE△1-sul1 had a high detection rate, producing new demands to scientifically and effective use of disinfectants.
|
PDF Full Text Request