大肠埃希菌与肺炎克雷伯菌中质粒介导的rmtA及rmtB甲基化酶基因检测研究  

Study of plasmid-mediated 16S rRNA methylase genes rmtAand rmtBamong clinical isolates of Klebsialla pneumoniae and Escherichia coli

作　　者：郑燕青[1] 马晓波[1] 房丽丽[1] 林贵兰[1] 陈世东[1] 郑港森[1] 李珣[1] 

机构地区：[1]厦门大学附属第一医院暨福建医科大学教学医院检验科,福建厦门361003

出　　处：《中华医院感染学杂志》2016年第5期964-966,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81302529)

摘　　要：目的检测质粒介导的16S rRNA甲基化酶基因rmtA和rmtB,在临床分离的产超广谱β-内酰胺酶（ESBLs）或耐阿米卡星大肠埃希菌和肺炎克雷伯菌中的分布,为临床合理用药提供依据。方法细菌的鉴定和药敏试验采用VITEK-2Compact系统,ESBLs阳性细菌采用双纸片协同试验证实,采用PCR法检测rmtA和rmtB基因。结果 108株细菌均未检测到rmtA基因,肺炎克雷伯菌和大肠埃希菌中rmtB基因的检出率分别为15.4%和1.8%;对于产ESBLs菌株,12.0%的肺炎克雷伯菌包含rmtB基因而大肠埃希菌未检出;20.0%~62.5%的阿米卡星耐药菌株检测到rmtB基因,且rmtB基因阳性菌株同时对庆大霉素和妥布霉素耐药;肺炎克雷伯菌和大肠埃希菌对阿米卡星、庆大霉素及妥布霉素的耐药率分别为15.4%与8.9%、42.3%与62.5%、21.2%与28.6%。结论在肺炎克雷伯菌和大肠埃希菌临床分离株存在16S rRNA甲基化酶基因,且阿米卡星耐药菌rmtB基因阳性率相对高,所有菌株未检出rmtA基因。OBJECTIVE To investigate the prevalence of rmtAand rmtBamong 108 unique isolates of K.Pneumoniae and E.coli,producing ESBLs or resistant to amikacin,in order to provide evidence for clinical rational antimicrobial therapy.METHODSIdentification and antimicrobial susceptibility were performed by Vitek-2compact automated system,and confirmation of ESBLs was evaluated.And the existence of rmtAand rmtB were carried out by PCR amplification.RESULTS The signal of rmtA was negative among 108 strains,and the presence of rmtB was1.8%~15.4%.The prevalence of rmtB was 12.0% among these K.Pneumoniae producing ESBLs.During isolates resistant to amikacin,the existence of rmtB were 20.0% for E.coli and 62.5% for K.Pneumonia,and rmtB-containing isolates were also resistant to gentamycin and tobromycin.The prevalence of K.Pneumoniaand E.coli resistant to amikacin,gentamicin and tobramycin were 15.4%and 8.9%,42.3%and 62.5%,21.2%and28.6%,respectively.RESULTS CONCLUSION The data suggest the emergence of 16 SrRNA methylase among clinical isolates of K.Pneumoniae and E.coli.The presence of rmtBis relatively high among amikacin-resistant strains,and no isolate is found to contain rmtA.

关 键 词：rmtA基因 rmtB基因 氨基糖苷类耐药 16S rRNA甲基化酶 超广谱Β-内酰胺酶 

分 类 号：R378.21[医药卫生—病原生物学]