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目的探讨新生儿粪便中产超广谱β-内酰胺酶(ESBL)菌产生途径,了解新生儿肠道产ESBL菌基因及耐药性。方法收集医院出生的健康新生儿及其母亲的粪便样本,应用选择性ESBL培养基进行细菌培养;培养阳性菌株应用飞行时间质谱仪进行菌种鉴定;全基因组测序技术进行ESBL基因型和耐药基因检测。结果 146份新生儿粪便标本,产ESBL菌阳性检出率8.90%,其中第1次排便产ESBL菌阳性检出率3.23%;出生72 h后粪便产ESBL菌阳性检出率为13.10%;13株产ESBL菌中CTX型9株,TEM型3株,SHV型1株;9株CTX型包括CTX-M-24、CTX-M-18、CTX-M-27、CTX-M-42和CTX-M-15五种型别。167份母亲粪便标本,产ESBL菌阳性检出率21.6%;ESBL基因型包括CTX型24株,TEM型6株,SHV型4株,Qnr S型2株;24株CTX型包括CTX-M-24、CTX-M-14、CTX-M-18、CTX-M-27、CTX-M-42和CTX-M-15。母婴共有12份标本检出2种或3种ESBL基因型。母婴49株产ESBL菌共检出aad A5、str A、str B、sul1、sul2和dfr A17等6种耐药基因;母婴同时检出产ESBL菌者,其耐药基因完全一致;7例新生儿和23例母亲粪便检出多种耐药基因。结论住院分娩新生儿在院期间可与母亲同时或单独在肠道检出产ESBL菌;新生儿肠道产ESBL菌产生途径有多种;产ESBL菌基因型和耐药基因种类较多。
Objective To investigate the pathogenic mechanism of extended-spectrum β-lactamase (ESBL) producing bacteria in newborn stool and to understand the gene and drug resistance of ESBL-producing bacteria in neonates. Methods Stool samples from healthy newborns and their mothers born in hospitals were collected and cultured in selective ESBL medium. Positive strains were cultured and identified by time-of-flight mass spectrometry. Whole-genome sequencing was used to detect ESBL genotypes and drug resistance genes Detection. Results Among 146 newborn stool samples, the positive rate of ESBL-producing bacteria was 8.90%, the positive rate of ESBL-producing bacteria in the first defecation was 3.23%; the positive rate of ESBL-producing stool was 13.10% after 72 hours of birth; There were 9 CTX strains, 3 TEM strains and 1 SHV strain in ESBL-producing strains. 9 CTX strains including CTX-M-24, CTX-M-18, CTX-M-27, CTX-M-42 and CTX -M-15 five types. The positive rate of ESBL-producing bacteria in 167 fecal samples was 21.6%. ESBL genotypes included 24 strains of CTX, 6 strains of TEM, 4 strains of SHV and 2 strains of Qnr S. 24 strains of CTX including CTX-M- 24, CTX-M-14, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. A total of 12 samples from mothers and infants detected 2 or 3 ESBL genotypes. A total of 49 strains of ESBL-producing maternal and child strains were detected, including aad A5, str A, str B, sul1, sul2 and dfr A17 and other resistant genes; Cases of newborns and 23 cases of mother stool detected a variety of drug resistance genes. Conclusion ESBLs can be detected in the intestine of newborn infants born in hospital or at the same time during their hospitalization. There are many ways to produce ESBLs in the intestine of newborns. There are many genotypes and genes of ESBL-producing bacteria.