肺炎克雷伯菌氨基糖苷类修饰酶耐药基因研究  

Study on drug resistance genes of aminoglycoside modifying enzymes among Klebsiella pneumoniae

作　　者：叶春枚[1,2] 刘文恩[1] 

机构地区：[1]中南大学湘雅医院,湖南长沙410008 [2]长沙市中医医院(市八医院)

出　　处：《实用预防医学》2015年第7期863-865,共3页Practical Preventive Medicine

摘　　要：目的检测肺炎克雷伯菌氨基糖苷类修饰酶的分布,探讨肺炎克雷伯菌对氨基糖苷类药物耐药机制。方法收集中南大学湘雅医院2009年1-7月间非重复肺炎克雷伯菌96株,所有菌株采用法国梅里埃公司的全自动微生物鉴定系统VITEK-2的革兰阴性菌GN卡鉴定和AST GN-13卡进行药敏分析。采用PCR法对氨基糖苷类修饰酶基因aac(3)-Ⅰ、aac(6′)-Ⅰb、ant(3″)-Ⅰ、aph(3′)-Ⅵ进行检测。结果经PCR扩增及测序分析,96株肺炎克雷伯菌中有18.8%的菌株携带aac(3)-Ⅰ基因(18/96)、57.3%的菌株携带aac(6′)-Ⅰb基因(55/96)、3.1%的菌株携带ant(3″)-Ⅰ基因(3/96),未扩增出aph(3′)-Ⅵ基因。结论在湖南地区发现aac(3)-Ⅰ、aac(6′)-Ⅰb、ant(3″)-Ⅰ型氨基糖苷类修饰酶基因,氨基糖苷类修饰酶基因以aac(6′)-Ⅰb为主。是肺炎克雷伯菌对氨基糖苷类药物高水平耐药的主要机制之一。Objective To detect the distribution of aminoglycoside modifying enzymes in Klebsiella pneumonia, and to explore the mechanism of resistance against aminoglycosides among Klebsiella pneumonia. Methods Ninety - six non - repetitive clinical isolates of Klebsiella pneumoniae were collected from Xiangya Hospital of Central South University from January to July, 2009. All of the isolates were identified by Bioerieus automatic microbiological - assay system VITEK - 2 using GN cards, and their antibacterial susceptibilities were tested by using AST GIN - 13 cards. Aminoglycoside modifying enzymes, including aac （3）- I, a^c（6＇）- I b, ant（S）- Iandaph（3＇）-VI weredetectedbyPCR. Results Amongaminoglycosidemodify- ing enzyme isolates of Klebsiella pneumoniae through PCR amplification and sequence analysis, the isolates carried with aac （ 3 ） - I , aac（6＇） - I b and ant（Y） - I respectively accounted for 18.8% （18/96）, 57.3% （55/96） and 3.1% （3/96）. aph （ 3＇ ） - VI was not identified from 96 isolates. Conelusions Aminoglycoside modifying enzymes, including aac （ 3 ） - I , aac （6＇） - I b and ant（3＇） - I ,have emerged for the first time in Human Province, and aac（6＇） - [ b is the most common gen- otype. Aminoglycoside modifying enzymes are one of the main mechanisms of high - level aminoglycoside resistance in Klebsiella pneumonia.

关 键 词：肺炎克雷伯菌 氨基糖苷类修饰酶 PCR 

分 类 号：R378[医药卫生—病原生物学]