耐β-内酰胺类肺炎克雷伯菌常见耐药元件与菌株亲缘性研究

发布时间：2018-01-27 15:32

  本文关键词： 耐β-内酰胺类肺炎克雷伯菌 获得性耐药基因 可移动遗传元件 样本聚类分析　出处：《中华医院感染学杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的调查耐β-内酰胺类肺炎克雷伯菌(DRKP)常见耐药元件的携带情况和菌株间的亲缘性。方法收集2014年1-12月医院住院患者痰液中分离到的30株DRKP,采用PCR分析17种β-内酰胺类、6种氨基糖苷类获得性耐药基因以及4种可移动遗传元件遗传标记,并对检测结果作样本聚类分析。结果 30株DRKP对β-内酰胺类(头孢唑林、头孢他啶、头孢呋辛、头孢噻肟等)、氨基糖苷类(庆大霉素、阿米卡星等)药物及环丙沙星均耐药,耐药率均为100.0%,对亚胺培南与美罗培南均敏感,耐药率均为0;每株DRKP均检出β-内酰胺类和氨基糖苷类药物获得性耐药基因及MGEs标记;样本聚类分析提示,30株DRKP有5组呈克隆传播,存在医院感染。结论β-内酰胺酶blaTEM、blaDHA基因,氨基糖苷类修饰酶aac(3)-Ⅱ、aph3′-Ⅰ基因,MGEs标记intⅠ1、IS903在DRKP中流行,是导致该组菌对多种抗菌药物耐药的重要原因,基于获得性耐药基因与可移动遗传元件标记检测结果的样本聚类分析是监控医院感染实用手段。
[Abstract]:Objective to investigate the 尾 -lactam resistant Klebsiella pneumoniae DRKP. Methods 30 strains of DRKP isolated from sputum of hospitalized patients from 2014 were collected. PCR was used to analyze 17 尾-lactams, 6 aminoglycoside acquired resistance genes and 4 transportable genetic elements. Results 30 strains of DRKP were treated with 尾 -lactam (cefazolin, ceftazidime, cefuroxime, cefotaxime, etc.) and aminoglycoside (gentamicin). Amikacin) and ciprofloxacin were both resistant, and the resistance rate was 100.0, sensitive to imipenem and meropenem, and the resistance rate was 0. 尾-lactam and aminoglycoside acquired drug resistance genes and MGEs markers were detected in each DRKP strain. Cluster analysis showed that 5 groups of DRKP strains were cloned and infected with nosocomial infection. Conclusion 尾 -lactamase blaTEM blaDHA gene is present. Aminoglycoside modifying enzyme aacan- 鈪，

本文编号：1468797