产IMP-4型金属β-内酰胺酶多药耐药产酸克雷伯菌耐药基因分析  

Integrons Containing IMP-4 Metallo-β-lactamases(MBLs) Gene among Multiple-drug-resistant Klebsiella oxytoca Strains

作　　者：陈惠玲[1] 叶惠芬[1] 周小棉[1] 熊剑辉[1] 吴俊[1] 

机构地区：[1]广州医学院附属广州市第一人民医院检验科,广东广州510180

出　　处：《中华医院感染学杂志》2008年第11期1512-1515,共4页Chinese Journal of Nosocomiology

基　　金：广东省医学科学技术研究基金资助项目(A2005537)

摘　　要：目的了解产IMP-4型获得性金属β-内酰胺酶产酸克雷伯菌耐药基因存在的状况。方法分别采用K-B法、双纸片增效法、Etest法、聚合酶链反应(PCR)及序列分析方法检测其产金属β-内酰胺酶(MBLs)表型及相关的耐药基因。结果多药耐药产酸克雷伯菌除对阿米卡星、多黏菌素B敏感外,对碳青酶烯类、三代、四代头孢菌素、头孢西丁、氟喹诺酮类、头孢哌酮/舒巴坦、复方新诺明、阿莫西林/克拉维酸、替卡西林/克拉维酸、哌拉西林、哌拉西林/他唑巴坦、利福平等均耐药;金属β-内酰胺酶基因型别为IMP-4型(blaIMP-4)、intⅠ1、qacEΔ1-sul1、aadA1、AmpC(blaADC)、CTX-M-14基因阳性。结论产酸克雷伯菌的多药耐药与整合子相关,且携带有多种耐药基因。OBJECTIVE To analyze the sequence of IMP-4 metallo-β-lactamases （MBLs） encoding gene from clinical isolates of multiple-drug-resistant Klebsiella oxytoca strains and attempt to know the integrons composing the drug resistance gene box. METHODS The antibiotic sensitivity test of multi-resistant K. oxytoca strains was done according to Kirby-Bauer method of CLSI 2005, and the double disk synergy test and Etest were for detecting their MBLs. The Class 1 integrons were detected by PCR. The purified amplicons of Class 1 integrons were sequenced. The type and order of gene cassettes in integrons were analyzed by searching GenBank. RESULTS The K. ozytoca was resistant to carbapenems, the third-generation cephalosporins, cefoxitin, quinolones, cefoperazone/ sulbactam, sulfamethoxazole/trimethoprim,amoxicillin/clavulanate, ticacillin/clavulanate, piperacillin, cefepime, rifampicin and piperacillin/tazobatam, only susceptible to amikacin and polymyxin B. The IMP-4 metallo-β- lactamases,aadA1, AmpC, CTX-M-14, qacEAl-sull and intI1 were positive. CONCLUSIONS Integrons are important molecular mechanism in the development of multidrug resistance. There are resistance gene boxes in them.

关 键 词：IMP-4基因型 金属Β-内酰胺酶 产酸克雷伯菌 

分 类 号：R378[医药卫生—病原生物学]