16SrRNA甲基化酶在肺炎克雷伯菌中流行情况调查  

Prevalence of 16SrRNA methylase in Klebsiella pneumoniae

作　　者：周勇[1] 张春玲[1] 陈文举[1] 王燕[1] 张黎明[1] 

机构地区：[1]台州市中心医院检验中心,浙江台州318000

出　　处：《中国预防医学杂志》2013年第12期933-935,共3页Chinese Preventive Medicine

基　　金：台州恩泽医疗集团C类项目(2009EZC05)

摘　　要：目的了解台州地区肺炎克雷伯菌临床分离株中16SrRNA甲基化酶流行情况,为临床感染的预防和治疗提供参考资料。方法收集台州地区2010年1月~2012年12月住院患者标本中分离的肺炎克雷伯菌共计859株,所有菌株均为非重复株。采用PCR及测序方法检测16SrRNA甲基化酶基因。结果 2010-2012年肺炎克雷伯菌对耐氨基糖苷类药物的耐药率逐年升高,经PCR扩增和DNA测序检出16SrRNA甲基化酶基因阳性株分别为2010年（14株,阳性率5.51%）、2011年（18株,阳性率6.22%）、2012年（21株,阳性率6.65%）,检测出的基因型为armA、rmtB两种类型且以rmtB为主,rmtA、rmtC、rmtD、npmA型均阴性。所有16SrRNA甲基化酶基因阳性肺炎克雷伯菌对氨基糖苷类药物高度耐药（MIC≥256mg/L）。结论肺炎克雷伯菌耐氨基糖苷类耐药率不断增加,16SrRNA甲基化酶在肺炎克雷伯菌中所占比重呈逐年升高的趋势,且16SrRNA甲基化酶基因阳性菌株对氨基糖苷类抗生素高度耐药。检测到16SrRNA甲基化酶基因型rmtB和armA,以rmtB为主。Objective To understand the prevalence of Klebsiella pneumoniae clinical isolates 16SrRNA methylase in Taizhou and provide reference information for the prevention and treatment of clinical infections. Methods 859Klebsiella pneumoniae isolated from specimens of hospitalized patients from January 2010to December 2012 were collected in Taizhou.And all strains were non-repetitive strain.By PCR and sequencing methods 16SrRNA enzyme gene methylation. Results Klebsiella pneumoniae resistance rates to aminoglycoside resistance from 2010to 2012increased year by year.16SrRNA methylase gene-positive strains detected by PCR amplification and DNA sequencing were14in 2010（5.5%）and 18in 2011（6.2%）and 21in 2012（6.6%）.The genotypes detected were two types：armA and rmtB,mainly rmtB.AmtA,rmtC,rmtD, npmA types were all negative.All 16SrRNA methylase gene-positive Klebsiella pneumoniae bacteria were highly resistant to aminoglycosides（MIC≥256mg/l）. Conclusions Klebsiella pneumoniae resistance to aminoglycoside resistance rate is increasing.16SrRNA methylase proportion was increasing trend in Klebsiella pneumoniae,and 16SrRNA methylase gene-positive strains were highly resistant to aminoglycoside antibiotics.The genotype rmtB and armA of 16SrRNA methylase were detected,mainly rmtB.So more attention should be paid to drug-resistant bacteria prevention isolation,prevent cross infection,reasonable use of antibiotics.

关 键 词：肺炎克雷伯菌 16SRRNA甲基化酶 氨基糖苷类 耐药 基因 

分 类 号：R446.5[医药卫生—诊断学]