产ESBLs肺炎克雷伯菌的整合子介导耐药的研究  

Study on the Drug Resistance Induced by Integrin in ESBLs-producing Klebsiella pneumoniae

作　　者：郝家砚[1] 程邦宁[1] 

机构地区：[1]安徽省立儿童医院检验中心,合肥230051

出　　处：《国外医药（抗生素分册）》2014年第1期16-18,22,共4页World Notes on Antibiotics

摘　　要：目的研究产ESBLs肺炎克雷伯菌临床分离株的耐药性、整合子的分布以及ESBLs的基因表型,探讨整合子介导的耐药机制在产ESBLs菌耐药性中的作用。方法对368株产ESBLs肺炎克雷伯菌进行PCR检测,分析其整合子结构基因以及ESBLs基因(bla TEM、bla SHV和bla CTX-M)。结果Ⅰ类整合子、bla SHV、bla TEM、bla CTX-M的检测率分别为54.35%、40.93%、42.75%、44.82%,未检测到Ⅱ、Ⅲ类整合子阳性菌;携带bla SHV基因的菌株检测到Ⅰ类整合子的比例显著高于携带bla TEM基因和bla CTX-M基因的菌株(P<0.01);环丙沙星、头孢吡肟、左旋氧氟沙星和哌拉西林外,整合子阳性和整合子阴性产ESBLs肺炎克雷伯菌株对其他8种抗生素的耐药率不同(P<0.05)。结论我院产ESBLs肺炎克雷伯菌中整合子以Ⅰ类整合子为主,Ⅱ类和Ⅲ类整合子较少;我院ESBLs肺炎克雷伯菌bla CTX-M比例略高;Ⅰ类整合子参与产ESBLs肺炎克雷伯菌耐药性的形成。Objective To study the drug resistance, integron distribution and gene phenotype of ESBLs in ESBLs-producing Klebsiella pneumonia, and explore the effect of integron to the drug resistance in ESBLs-producing Klebsiella pneumonia. Methods The gene phenotype （blaTEM, blasrtv and blacTx.M） and integron distribution in ESBLs- producing Klebsiella pneumonia were analyzed by PCR. Results The positive rates of int I, SHV, TEM, CTX-M were 54.35%, 40.93%, 42.75%, 44.82%, no strain with integron of Class II and III; The proportion of strains with blasHv was much higher than that with blareM and blaa^M. The drug resistence to the other 8 antibiotic was different in ESBLs- producing Klebsiella pneumonia with integron compared with that in ESBLs-producing Klebsiella pneumonia without integron, except ciprofloxacin, cefepime, amikacin, levofloxacin and piperacillin （P 〈 0.01）. Conclusion The integron in ESBLs-producing Klebsiella pneumonia separated from our hospital is mostly class I, and class II and III is much less; The gene phenotype proportion of ESBLs-producing Klebsiella pneumonia separated from our hospital is a little higher; The integron of class I involes the formation of drug resistence in ESBLs-producing Klebsiella pneumonia.

关 键 词：肺炎克雷伯菌 ESBLS 整合子 耐药 

分 类 号：R378[医药卫生—病原生物学]