肺炎克雷伯菌对喹诺酮类及氨基糖苷类耐药基因检测分析  

Detection of resistance gene of klebsiella pneumoniae on quinolones and aminoglycosides

作　　者：胡伟 马淑慧 李雄伟 田锋奇 肖成成 何燕 段真珍 

机构地区：[1]信阳市中心医院药学部,河南信阳464000 [2]信阳市中心医院检验科 [3]郑州大学附属肿瘤医院药学部,郑州450008

出　　处：《医药论坛杂志》2016年第8期43-44,共2页Journal of Medical Forum

摘　　要：目的探讨临床分离的肺炎克雷伯菌对氨基糖苷类、喹诺酮类药物的耐药及耐药基因携带情况。方法从近两年信阳市中心医院收治患者的标本中分离出肺炎克雷伯菌40株,采用VITEK-2型全自动细菌鉴定系统鉴定细菌;纸片琼脂扩散法检测细菌对氨基糖苷类及喹诺酮类药物的敏感性;并采用聚合酶链反应检测耐药基因aac(6)-Ib,qnr S、qnr A、qnr B。观察并比较细菌对两组药物的耐药情况以及耐药基因检测结果。结果 40株肺炎克雷伯菌中,对氨基糖苷类药物庆大霉素、妥布霉素、阿米卡星的耐药率分别为97.50%、52.50%、28.50%;耐药基因aac(6’)-Ⅰb的检出率为50.00%。肺炎克雷伯菌对喹诺酮类药物环丙沙星、加替沙星、左氧氟沙星的耐药率分别为90.00%、82.50%、92.50%;喹诺酮类耐药基因qnr S检出率为35.00%,qnr B基因检出率为17.50%,qnr A基因检出率为0.00%,(可加qnr基因总阳性率52.5%)。结论肺炎克雷伯菌的耐药基因中qnr基因较常见,而其对氨基糖苷类药物产生耐药的主要原因是携带aac(6’)-Ⅰb基因。Objective To investigate the carrying condition of klebsiella pneumoniae on quinolones and aminoglycosides. Methods Totally 40 klebsiella pneumoniae isolated from specimens in our hospital the recent two years were selected. VITEK- 2 automatic bacteria identification system used to identify bacteria. Disc agar diffusion used to detect sensibility of bacteria on quinolones and aminoglycosides. PCR used to detect resistance gene aac（ 6）- Ib,qnr S、qnr A、qnr B. Observed and compared the drug resistance situation and resistance gene detection results. Results Of 40 klebsiella pneumoniae, drug resistance rate of gentamicin, tobramycin, amikacin on aminoglycosides were 97. 50%,52. 50%,28. 50%; detection rate of resistance gene aac（ 6＇）- Ⅰb was 50. 00%. Drug resistance rate of quinolones on CPFX,gatifloxacin and levofloxacin were 90. 00%,82. 50%,92. 50%; qnr S detection rate of quinolone resistance gene was 35. 00%,qnr B gene detection rate was 17. 50%,qnr A gene detection rate was 0. 00%（ qnr total positive rate of gene was 52. 5%）. Conclusion Qnr gene is common in drug resistance gene of klebsiella pneumoniae and the major reason of its drug resistance on aminoglycosides is the carry of aac（ 6＇）- Ⅰb gene.

关 键 词：耐药基因 肺炎克雷伯菌 喹诺酮类 氨基糖苷类 

分 类 号：R978.1[医药卫生—药品]