产ESBL肺炎克雷伯菌的β-内酰胺类与氨基糖苷类和磺胺类耐药元件分析

发布时间：2018-05-18 03:32

本文选题：肺炎克雷伯菌 + 耐药　；参考：《中华医院感染学杂志》2017年21期

【摘要】：目的调查一组20株产ESBL肺炎克雷伯菌中β-内酰胺类、氨基糖苷类与磺胺类获得性耐药元件基因的携带状况,以及菌株间的亲缘关系。方法收集2015年1月-6月医院住院患者标本中分离的20株产ESBL肺炎克雷伯菌,采用聚合酶链反应(PCR)及序列分析的方法分析23种β-内酰胺类耐药基因、11种氨基糖苷类耐药基因、5种磺胺类耐药基因、8种可移动遗传元件遗传标记,阳性耐药基因测序后直接作BLAST比对,耐药基因检测结果作样本聚类分析(UPGMA法)。结果 20株产ESBL肺炎克雷伯菌每株均检出β-内酰胺类耐药基因、磺胺类耐药基因和可移动遗传元件遗传标记基因,阳性率达100.0%,有19株检出氨基糖苷类药物获得性耐药基因,阳性率95.0%;20株菌共检出6种β-内酰胺酶类耐药基因、4种氨基糖苷类耐药基因、3种磺胺类耐药基因、6种可移动遗传元件遗传标记,且阳性率较高;样本聚类分析显示菌株有聚集性,共有12-14号株、7-20号株、15-18-19号株、8-9号株4个克隆传播。结论本组20株产ESBL肺炎克雷伯菌携带的β-内酰胺类耐药基因、氨基糖苷类耐药基因、磺胺类耐药基因和可移动遗传元件遗传标记是对β-内酰胺类、氨基糖苷类、磺胺类产生耐药的重要原因,本组菌检出的四个克隆高度疑似医院感染。
[Abstract]:Objective to investigate the carrying status of 尾 -lactams, aminoglycosides and sulfamethylamine acquired drug resistance element genes in 20 strains of Klebsiella pneumoniae producing ESBL, and the relationship between them. Methods from January to June 2015, 20 strains of Klebsiella pneumoniae were isolated from hospitalized patients. Polymerase chain reaction (PCR) and sequence analysis were used to analyze 23 尾 -lactam resistance genes, 11 aminoglycoside resistance genes, 5 sulfamide resistance genes and 8 transportable genetic elements. The positive drug resistance genes were compared with BLAST directly after sequencing, and the results of drug resistance gene analysis were analyzed by UPGMA method. Results 尾 -lactam resistance genes, sulfamethylamine resistance genes and transportable element genetic marker genes were detected in 20 strains of Klebsiella pneumoniae. The positive rate was 100.00.Aminoglycoside acquired drug resistance genes were detected in 19 strains of Klebsiella pneumoniae. A total of 6 尾 -lactamases resistant genes, 4 aminoglycoside resistance genes, 3 sulfadiazine resistance genes and 6 transportable genetic element genetic markers were detected in 20 strains, and the positive rate was high, and the sample cluster analysis showed that the strains were clustered. A total of 12-14 strains, 7-20 strains, 15-18-19 strains and 8-9 strains were cloned and transmitted. Conclusion 20 strains of Klebsiella pneumoniae produced 尾 -lactam, aminoglycoside, sulfonamide-resistant and transportable genetic markers of 尾 -lactam, aminoglycoside, 尾 -lactam and aminoglycoside. Four clones were highly suspected of nosocomial infection.
【作者单位】：湖北省监利县人民医院检验科;宁波市第一医院检验科;
【基金】：浙江省中医药基金资助项目(2011ZB126)
【分类号】：R446.5

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