社区肺炎克雷伯菌耐药性分析及耐药基因的研究  

Resistance of Community-acquired Klebsiella pneumoniae Isolates and Its Ten Resistant Genes

作　　者：杜苏萌[1] 周永安[2] 张润梅[3] 康建邦[3] 徐辉[3] 武素梅[2] 杨素萍[1] 

机构地区：[1]山西大学生物技术研究所,山西太原030006 [2]山西省儿童医院分子微生物,山西太原030013 [3]山西医科大学附属第二医院药敏实验室,山西太原030001

出　　处：《中华医院感染学杂志》2009年第12期1485-1488,共4页Chinese Journal of Nosocomiology

基　　金：山西省自然科学基金(20051104)

摘　　要：目的研究山西医科大学第二附属医院肺炎克雷伯菌(KPN)耐药性以及10种耐药基因的检测。方法采用纸片琼脂扩散(K-B法)法测定临床分离的31株肺炎克雷伯菌对环丙沙星、头孢吡肟(FEP)、头孢西丁(FOX)等19种药敏纸片的耐药性,并选22株不同耐药株进行TEM、SHV、CTX-M1、CTX-M9、gyrA、gyrB、parC、parE、ompC、ompF 10种耐药基因进行PCR扩增。结果药敏试验显示有17株为耐药株,8株为敏感菌株,有6株中介,5株超广谱β-内酰胺酶(ESBLs)表型试验为阳性;PCR扩增试验显示10种耐药基因均能扩增出,其中SHV型超广谱β-内酰胺酶基因17株居首,13株ompF、16株parC、15株gyrB型基因相对4株ompC、6株parE、8株gyrA型氟喹诺酮耐药基因。结论社区肺炎克雷伯菌中普遍存在ESBLs型基因,DNA旋转酶基因、拓扑异构酶Ⅳ基因、外膜蛋白基因,应加强耐药基因的检测,减少耐药株出现。OBJECTIVE To study the drug resistance and detection of ten resistance genes. METHODS The resistance of 31 clinically isolated strains of Klebsiella pneumoniae to ciprofloxacin, cefepime and cefoxitin was determined by K-B method. The genes of TEM, SHV, CTX-M1, CTX-M9, gyrA, gyrB, parC, parE, ompC, and ompF in the 22 strains were amplified by PCR. RESULTS Seventeen resistant strains, 8 sensitive strains, 6 mediates and 5 ESBLs strains were found. PCR results showed that ten resistant genes could all be amplified out. Among ESBLs resisant genes SHV was found in 17 strains which ranked the first, ompF in thirteen , parC then in sixteen and gyrB genes in fifteen and among fluoroquinomones resistant genes with four there were ompC, in four strains pare in six and gyrA in eight. CONCLUSIONS The genes of ESBLs DNA gyrase DNA TopoisomerasesⅣ and outer membrane exist commonly in the strains of K. pneumoniae. So we should highlight the inspection of genes to reduce the resistant strains.

关 键 词：肺炎克雷伯菌 超广谱Β-内酰胺酶 DNA旋转酶 DNA拓扑异构酶Ⅳ 外膜蛋白 

分 类 号：R378.996[医药卫生—病原生物学]