耐碳青霉烯类肺炎克雷伯菌获得性耐药基因检测与分析

发布时间：2018-03-21 08:23

  本文选题：肺炎克雷伯菌　切入点：耐碳青霉烯类　出处：《中华医院感染学杂志》2015年19期 　论文类型：期刊论文

【摘要】：目的了解耐碳青霉烯类肺炎克雷伯菌获得性耐药基因存在状况及与常见可移动遗传元件的关系,探讨其耐药机制。方法收集2011年1月-2012年6月医院住院患者分离到的20株耐碳青霉烯类肺炎克雷伯菌(菌种经gyrA基因测序确认),采用聚合酶链反应法分析76种β-内酰胺类、氨基糖苷类、喹诺酮类获得性耐药基因与可移动遗传元件标记基因,并对检测结果作指标与样本聚类分析。结果β-内酰胺类与氨基糖苷类获得性耐药基因及可移动遗传元件遗传标记,每株均有阳性发现;20株菌共检出2种β-内酰胺类药物获得性耐药基因、4种氨基糖苷类药物获得性耐药基因、1种喹诺酮类药物获得性耐药基因、5种可移动遗传元件遗传标记;阳性基因可分为8种阳性模式;指标聚类分析提示,β-内酰胺类药物获得性耐药基因blaKPC、blaTEM与可移动遗传元件标记intⅠ1、ISEcp1、ISKpn6高度连锁,氨基糖苷类药物获得性耐药基因rmtB与插入序列IS903也高度关联;样本聚类分析提示,20株菌可分为A、B两个簇群;A簇群又可分为A1和A2两个亚簇群,A1亚簇群中的1~2、7~9号株、11~12号株3组分别为克隆传播,B簇群也可分为B1和B2两个亚簇群,B1与B2亚簇群分别为克隆传播。结论该组菌株对β-内酰胺类、氨基糖苷类药物耐药表型与基因型一致,指标聚类分析提示获得性耐药相关基因和可移动遗传元件密切相关,样本聚类分析提示本组菌株存在多个克隆传播。
[Abstract]:Objective to investigate the presence of acquired drug resistance genes of Klebsiella pneumoniae resistant to carbapenem and its relationship with common mobile genetic elements. Methods from January 2011 to June 2012, 20 strains of Klebsiella pneumoniae resistant to carbapenem (identified by gyrA gene sequencing) were collected and analyzed by polymerase chain reaction (PCR). Aminoglycosides, quinolones acquired resistance genes and transportable genetic element marker genes, Results the acquired drug resistance genes of 尾 -lactams and aminoglycosides and the genetic markers of mobile genetic elements were analyzed. Two 尾 -lactam acquired drug resistance genes, four aminoglycoside acquired resistance genes, one quinolone acquired resistance gene and five transportable genetic element genetic markers were found in 20 strains. The positive genes can be divided into 8 positive patterns, and the results of cluster analysis indicate that the 尾 -lactam acquired drug resistance gene blaKPC-blaTEM is highly linked to the mobile genetic element marker int 鈪，

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