耐药肺炎克雷伯菌湖北襄阳分离株获得性耐药元件研究

发布时间：2018-10-29 22:09

【摘要】：目的调查耐药肺炎克雷伯菌获得性耐药元件基因的携带情况及菌株间的亲缘关系,为临床治疗提供参考依据。方法收集2016年1-10月医院住院患者痰液标本分离15株耐药肺炎克雷伯菌,用K-B法测定9种抗菌药物的敏感性,采用聚合酶链反应(PCR)及序列分析的方法分析35种β-内酰胺类获得性耐药基因,21种氨基糖苷类获得性耐药基因和10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。结果 15株耐药肺炎克雷伯菌对β-内酰胺类、氨基糖苷类、喹诺酮类耐药率高;15株菌每株均检出β-内酰胺酶基因,总阳性率达100.0%,共检出7种β-内酰胺酶基因,其中仅检出1种β-内酰胺酶基因1株,占6.7%,同时检出2种9株,占60.0%,同时检出3种5株,占33.3%;样本聚类分析可见有一定的聚集性,并可分为A与B二个群;除A群有2个菌株属克隆传播,其余菌株亲缘关系稍远。结论本组15株耐药肺炎克雷伯菌同时携带β-内酰胺类药物获得性耐药基因、氨基糖苷类药物获得性耐药基因和可移动遗传元件遗传标记,是对β-内酰胺类和氨基糖苷类产生耐药的重要原因。
[Abstract]:Objective to investigate the gene carrying of acquired drug resistance element and the relationship between the two strains so as to provide a reference for clinical treatment of Klebsiella pneumoniae. Methods from January to October 2016, 15 strains of Klebsiella pneumoniae were isolated from sputum of hospitalized patients, and the sensitivity of 9 antimicrobial agents was determined by K-B method. Polymerase chain reaction (PCR) and sequence analysis were used to analyze 35 尾 -lactam acquired drug resistance genes, 21 aminoglycoside acquired drug resistance genes and 10 transportable genetic element genetic markers. The positive drug resistance genes were compared with BLAST directly after sequencing, and the results of drug resistance genes were analyzed by cluster analysis. Results the resistant rates of 15 strains of Klebsiella pneumoniae to 尾 -lactams, aminoglycosides and quinolones were high. 尾 -lactamase genes were detected in each of the 15 strains, and the total positive rate was 100.00.A total of 7 尾 -lactamases genes were detected, among which only one 尾 -lactamase gene was detected, accounting for 6.7%, and two kinds of 9 strains were detected at the same time. At the same time, 3 species and 5 plants were detected, accounting for 33. 3%. Cluster analysis showed that there was a certain degree of aggregation and could be divided into two groups A and B. except two strains in group A were cloned and transmitted, the relationship of the other strains was slightly distant. Conclusion the 15 strains of Klebsiella pneumoniae also carry 尾 -lactam acquired drug resistance genes, aminoglycoside acquired drug resistance genes and transportable genetic elements. It is an important cause of resistance to 尾-lactams and aminoglycosides.
【作者单位】：湖北医药学院附属襄阳市第一人民医院;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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