产ESBLs大肠埃希菌获得性耐药元件指标聚类分析  

Index cluster analysis of acquired resistance genes in ESBLs producing Escherichia coli

作　　者：李海英[1] 白雅红 王华[1] 白咪红 

机构地区：[1]宝鸡市人民医院检验科,陕西宝鸡721000

出　　处：《中华医院感染学杂志》2014年第23期5725-5727,共3页Chinese Journal of Nosocomiology

基　　金：宝鸡市卫生局科研基金资助项目(2013-36)

摘　　要：目的探讨分析产ESBLs大肠埃希菌其水平获得性耐药基因和可移动遗传元件(MGEs)的携带状况,并分析各种水平获得性耐药基因与各种MGEs的相关性,为临床提供参考依据。方法收集医院2013年分离到的20株产ESBLs大肠埃希菌,检测了25种β-内酰胺类药物耐药相关的酶基因、12种氨基糖苷类药物耐药相关的酶基因、1种消毒剂与磺胺耐药重叠基因以及9种可移动遗传元件(MGEs)遗传标记,并用指标聚类分析法探讨水平获得性耐药基因和MGEs遗传标记的相关性。结果 20株产ESBLs大肠埃希菌共检出6种β-内酰胺酶基因、4种氨基糖苷类修饰酶基因、1种消毒剂与磺胺耐药重叠基因以及7种可移动遗传元件遗传标记;指标聚类分析(UPGMA法)提示β-内酰胺酶基因blaTEM、blaCTX-M-9 cluster,氨基糖苷类修饰酶基因aac(3)-Ⅱ、aac(6′)-Ⅰb、aadA5,消毒剂与磺胺耐药重叠基因qacE△1-sul1与可移动遗传元件intⅠ1、ISEcp1、IS26、IS903、traA、trbC可能存在关联,其中消毒剂与磺胺耐药重叠基因qacE△1-sul1与Ⅰ类整合子的整合酶基因intⅠ1存在高度关联。结论产ESBLs大肠埃希菌携带获得性耐药基因可导致对相关抗菌药物耐药,且可移动遗传元件的水平转移使细菌耐药性在同种细菌之间甚至不同种细菌菌株之间得以快速传播;指标聚类分析提示β-内酰胺酶基因blaTEM、blaCTX-M-9 cluster,氨基糖苷类修饰酶基因aac(3)-Ⅱ、aac(6′)-Ⅰb、aadA5,消毒剂与磺胺耐药重叠基因qacE△1-sul1为可移动遗传元件介导。OBJECTIVE To investigate the distribution of acquired resistance genes and mobile genetic elements （MGEs） ,and their relationships in a group of ESBLs producing Escherichia coli （E .coli） so as to provide refer‐ence for clinical treatment .METHODS Totally 20 strains of ESBLs producing E .coli were isolated from Baoji Peo‐ple′s Hospital in the year 2013 .T hen ,25 kinds of beta‐lactamase related enzyme genes ,12 kinds of aminoglyco‐side related enzyme genes ,1 kind of overlapping gene of disinfectant and sulfonamides ,and 9 kinds of genetic markers of MGEs were tested .And the index cluster analysis （UPGMA method） was used to investigate the rela‐tionships between acquired resistance genes and genetic markers of MGEs .RESULTS In this group of ESBLs pro‐ducing E .coli ,6 kinds of beta‐lactamase genes ,4 kinds of aminoglycoside modifying enzyme genes ,1 kind of overlapping gene of disinfectant and sulfonamides ,7 kinds of genetic markers of MGEs were positive .The index cluster analysis suggested that correlations existed between acquired resistance genes blaTEM ,blaCTX‐M‐9 clus‐ter ,aac（3）‐Ⅱ ,aac（6′）‐Ⅰb ,aadA5 ,qacE△1‐sul1 and mobile genetic elements intⅠ1 , ISEcp1 , IS26 , IS903 , traA ,trbC ,and high correlations existed between the overlapping genes of disinfectant and sulfonamides qacE△1‐sul1 and intⅠ1 .CONCLUSION In this group of E .coli ,acquired resistance genes played a role in resistant pheno‐types of antimicrobial agents .And horizontal transfer of mobile genetic elements brought rapid spread of resistance among the same even different kinds of pathogens .In addition ,the index cluster analysis showed that acquired re‐sistance genes blaTEM ,blaCTX‐M‐9 cluster ,aac（3）‐Ⅱ ,aac（6′）‐Ⅰb ,aadA5 ,qacE△1‐sul1 can be mediated by MGEs .

关 键 词：大肠埃希菌 获得性耐药基因 指标聚类分析 超广谱β-内酰胺酶基因 

分 类 号：R378.21[医药卫生—病原生物学]