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目的：了解新疆独山子地区肺炎克雷伯菌超广谱β- 内酰胺酶（ESBLs）的发生率、作为指示剂的五种抗生素的检出情况及 ESBLs 主要基因型。方法：收集临床分离的148 株肺炎克雷伯菌，采用双纸片协同筛选法、NCCLS 推荐的表型筛选和确证试验对细菌进行ESBLs 产酶株的识别；耐药基因的质粒重组、转化，聚合酶链反应（PCR）扩增阳性产物测序，通过GenBank 对序确定基因型。结果：本地区肺炎克雷伯菌ESBLs 的分离率达31.1%，头孢曲松（CRO）安曲南（ATM）和头孢噻肟（CTX）头孢泊肟（CPD）、头孢他定（CAZ）作为指示剂检出率分别为97.8%、95.6%、93.4%、76.0%、65.2%；本地区产ESBLs 菌株耐药基因型CTXM- 22 占54.3%，CTX-M-18 占41.3%，TEM61.8%，52.1%的产ESBLs 肺炎克雷伯菌SHV 耐药基因阳性。结论：CRO、ATM 和CTX 对检测ESBLs 阳性率较高；CTX-M-22、CTX-M-18 是本地区产ESBLs 菌株的主要基因型。

英文摘要:

Objective: To make sure of the percentage for the occurrence rate of Klebsiella pneumonia extended-spectrum β-lactamases in dushanzi district in Xinjiang. In order to check conditions in the five types of antibiotic instrict and the main genotype of ESBLs. Method: Collected 148 escherichia coli, klebsiella from clinical separation, we used double paper sheet screen, diagram recommended by NCCLS method and conclusive evidence trial to identify the bacteria from ESBLs; Reshuffle, conveyance and reaction of polymerase chain reaction (PCR) of medical gene resistant and enlarged the positive reaction of the order examination to pass homologue assurance of genotype by GenBank. Result: The percentage of the separation rate for escherichia coli, klebsiella cefpodoxime (CPD) and ceftazidime (CAZ) are following: 97.8% , 95.6% , 93.4% , 76.0% , 65.2% . Medical gene resistant CTX-M-22 of ESBLs generated in this area covers 54.3%. CTX-M-18 is 41.3%. TEM 61.8%,52.1% is klebsiella pneumonia SHV the positive of medical gene resistant. Conclusion:The positive rate of CRO, ATM, and CTX are relatively high for checking ESBLs. CTX-M-22, CTX-M-18 are the main genotype of ESBLs bacteria produced in the area.

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