acrAB外排泵对肺炎克雷伯菌耐环丙沙星作用的研究

发布时间：2018-01-22 09:45

本文关键词： 外排泵肺炎克雷伯菌泵抑制剂环丙沙星　出处：《中华医院感染学杂志》2016年16期 　论文类型：期刊论文

【摘要】：目的研究临床分离的肺炎克雷伯菌中外排泵基因表达及其对环丙沙星耐药性的影响,明确外排泵在肺炎克雷伯菌对环丙沙星耐药中的作用。方法收集医院2014年9月-2015年2月临床标本中分离的肺炎克雷伯菌36株,采用VITEK-2Compact全自动微生物鉴定仪进行鉴定;K-B纸片扩散法对抗菌药物进行敏感性测定;用PCR方法检测菌株中的外排泵基因;用微量稀释法检测抗菌药物的最低抑菌浓度(MIC)以及泵抑制剂羰基氰氯苯腙(CCCP)存在情况下,肺炎克雷伯菌对环丙沙星MIC值的变化。结果 36株肺炎克雷伯菌中,有16株对环丙沙星耐药,耐药率为44.44%;采用PCR技术对16株耐药菌的外排泵acrAB基因进行检测,其中只有9株耐药菌株的检测结果为阳性,acrAB基因的检出率为56.25%;加入CCCP后,acrAB基因阳性株中,有5株(55.56%)MIC值下降4~16倍,2株(22.22%)MIC值下降两倍,还有2株(22.22%)MIC值未下降。结论 acrAB外排系统是肺炎克雷伯菌耐环丙沙星的一个重要机制,泵抑制剂CCCP可有效抑制acrAB基因的外排作用。
[Abstract]:Objective to study the expression of efflux pump gene in clinically isolated Klebsiella pneumoniae and its effect on ciprofloxacin resistance. Methods 36 strains of Klebsiella pneumoniae isolated from clinical samples from September 2014 to February 2015 were collected to determine the role of efflux pump in the resistance of Klebsiella pneumoniae to ciprofloxacin. VITEK-2Compact automatic microbiological identification instrument was used for identification. The sensitivity of antimicrobial agents was determined by K-B disk diffusion method. The efflux pump gene was detected by PCR. Microdilution method was used to detect the minimum inhibitory concentration (MIC) of antimicrobial agents and the presence of pump inhibitor carbonyl cyanochlorobenzylhydrazone (CCCP). Results among the 36 strains of Klebsiella pneumoniae, 16 strains were resistant to ciprofloxacin, and the resistance rate was 44.44%. The exudation pump acrAB gene of 16 strains of drug-resistant strains was detected by PCR technique. Only 9 strains were positive for acrAB gene, the positive rate was 56.25%. Among the positive strains of acrAB gene in CCCP, 5 strains (55.56%) decreased their mics by 416 times and 2 strains (22.2%) by two times. Conclusion the efflux system of acrAB is an important mechanism of ciprofloxacin resistance of Klebsiella pneumoniae. Pump inhibitor CCCP can effectively inhibit the efflux of acrAB gene.
【作者单位】：绍兴市立医院检验科;哈尔滨医科大学微生物学教研室;
【基金】：国家自然科学基金资助项目(81101300)
【分类号】：R446.5
【正文快照】： 肺炎克雷伯菌是临床感染菌中分离率较高的革兰阴性菌,是引起医院感染的常见菌之一,其可导致消化道、呼吸道、泌尿生殖道等部位的感染[1]。以环丙沙星为代表的喹诺酮类抗菌药物作为临床应用处于第2位的化学合成抗菌药物,广泛用于肺炎克雷伯菌感染的治疗,同时临床肺炎克雷伯菌的

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