摘要
目的了解1株对临床常用18种抗菌药物(包括亚胺培南、美罗培南)均耐药的肺炎克雷伯菌(KPN)所携带的耐药基因状况。方法对该株KPN进行了9类耐药基因的PCR法检测,包括β-内酰胺酶基因blaTEM、blaSHV、blaLEN、blaOKP、blaCTX-M-1、2、9群、blaOXA-1、2、10群、blaCARB、blaPER、blaVEB、blaGES、金属β-内酰胺酶基因blaIMP、blaVIM、blaKPC,AmpC酶基因blaDHA、blaACT/MIR、blaCMY/MOX、blaCMY/LAT,氨基糖苷修饰酶基因aac(3)-Ⅰ、aac(3)-Ⅱ、aac(6′)-Ⅰb、aac(6′)-Ⅱ、ant(2″)-Ⅰ、ant(3″)-Ⅰ,喹诺酮类耐药基因qnrA、TMP耐药基因dfrA1、dfrA17,消毒剂磺胺耐药基因qacE△1-sul1,整合子遗传标记基因intⅠ1、intⅠ2、intⅠ3,转座子遗传标记基因tnpA、merA,共计36种。结果KPN共检出7种耐药基因,分别为β-内酰胺酶基因blaTEM,blaSHV,金属β-内酰胺酶基因blaKPC-2,氨基糖苷修饰酶基因aac(3)-Ⅱ,ant(3″)-Ⅰ,消毒剂磺胺耐药基因qacE△1-sul1,整合子遗传标记基因intⅠ1。结论在该株泛耐药KPN中发现了少见的blaKPC-2金属β-内酰胺酶基因,该菌对18种抗菌药物的耐药可能与其同时携带有多种耐药基因有关,临床应对此类菌株引起重视。
OBJECTIVE To understand the drug resistance genes in Klebsiella pneumoniae （KPN） isolate resistance to 18 kinds of antibacterials which included imipenem and meropenem. METHODS We detected 36 kinds of drug resistance genes for the strain of KPN by PCR method, included the beta-lactamases genes, blaTEM, blaSHV, blaLEN,blaOKP, （blaCTX-M-1, 2 and 9） groups, （blaOXA-1, 2 and 10） groups, CARB, PER, VEB and GES; the genes of metallo-beta-lactamases genes, IMP, VIM and KPC; the AmpC genes, DHA, ACT, MOX and LAT; the aminoglycosides resistant genes, aac（3）- Ⅰ , aac（3）-Ⅱ , aac（6′）- Ⅰ b, aac（6′）-Ⅱ , ant（Z＂）- Ⅰ and ant （3＂）-Ⅰ ; the quinolones resistant gene qnr; the TMP resistant genes, dfrA1 and dfrA17; the disinfectantsulfanilamide resistantgene, qacE△1-sull;the integron genes, int Ⅰ-1, int Ⅱ-2 and int Ⅱ-3; and the transposon genes, tnpA and merA. RESULTS We found 9 kinds of drug resistance genes in this KPN isolate. They were the beta-lactamases genes, blaTEM and blaSHV; the metallo-beta-lactamasesgene blaKPC-2; the aminoglycosides resistant genes, aac（3）-Ⅱ and ant（3＂）- Ⅰ ; the quinolones resistant gene qnr; the TMP resistant gene dfrA17; the disinfectant-sulfanilamide resistant gene qacE △1-sull and the integron genes int Ⅰ-1. CONCLUSIONS We discovere multiple drug resistant genes （some in the chromosome,some are plasmid-mediated） in this isolate. We also find the infrequent plasmid-mediated drug resistant gene blaKPC-2. We think it＇s concerned with the panresistant and the multi-drug resistant genes in this KPN,and we must pay highly attention to this isolate in clinic.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第13期1634-1637,共4页
Chinese Journal of Nosocomiology
基金
浙江省医学重点学科建设基金(07-010)
关键词
肺炎克雷伯菌
耐药基因
泛耐药
Klebsiella pneumoniae
Drug resistance genes
Pan-resistance
