多药耐药肺炎克雷伯菌β-内酰胺酶基因及膜孔蛋白基因研究  

Detection of β-lactamases genes and porin genes in multidrug-resistant Klebsiella pneumoniae

作　　者：凌月明[1] 陈金玉[2] 黄爱娥[1] 王建福[1] 王秋菊[1] 

机构地区：[1]解放军第180医院检验科,福建泉州362000 [2]解放军第180医院药剂科,福建泉州362000

出　　处：《中华医院感染学杂志》2012年第16期3448-3450,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院多药耐药肺炎克雷伯菌(MDRKP)β-内酰胺酶基因及膜孔蛋白基因分布。方法采用聚合酶链反应(PCR)法检测20株MDRKP 28种β-内酰胺酶基因与膜孔蛋白编码基因ompK36,并对ompK36-PCR产物进行全自动荧光法测序分析比对。结果 20株MDRKP中17株均检出β-内酰胺酶基因,分别为A类β-内酰胺酶中的TEM、CTX-M-1群和LAP基因,阳性率分别为55.0%、20.0%、15.0%,C类β-内酰胺酶中的LEN、DHA基因,阳性率分别为20.0%、30.0%;20株MDRKP均存在突变,4株为缺失性突变,16株检测到膜孔蛋白编码基因ompK36,序列比对分析该16株与敏感株序列均有差异。结论 TEM、CTX-M-1、LAP、LEN、DHA基因是MDRKP主要的β-内酰胺酶基因,医院MDRKP耐β-内酰胺类药物与产β-内酰胺酶和同时伴有膜孔蛋白ompK36基因突变均相关。OBJECTIVE To investigate the distribution of the β-lactamase genes and porin genes in multidrug- resistant Klebsiella pneurnoniae （MDRKP）. METHODS A total of 28 kinds of β-1actamase genes and porin ompK36 gene were assayed by polymerase chain reaction（PCR） in 20 MDRKP strains. The porin ornpK36 genes were sequenced. RESULTS Theβ-lactamase genes were detected in 17 out of 20 MDRKP strains, including TEM, CTX-M-1, LAP, LEN, and DHA gene, the positive rates were 55.0%, 20. 0%, 15.0%, 20.0M, and 30.0% respectively; mutation were detected in all 20 MDRKP strains, 4 strains were loss mutation, 16 strains were ompk36 gene mutation. The sequence analysis showed that there was difference in the Sequence between the 16 strains and the sensitive strains. CONCLUSION TEM, CTX-M-1, LAP, LEN, and DHA are the main β-lactamase genes in MDRKP of our hospital, the production of β-1actamase with mutation of porin ompK36 gene at the same time is associated with the drug resistance of MDRKP to β-1actams antibiotics.

关 键 词：多药耐药 肺炎克雷伯菌 Β-内酰胺酶基因 膜孔蛋白基因 

分 类 号：R378.996[医药卫生—病原生物学]