泛耐药肺炎克雷伯菌耐药基因检测及聚类分析  

Acquired resistance-related genes in pandrug-resistant Klebsiella pneumoniae and sample cluster analysis

作　　者：马红映[1] 汪丽[2] 虞亦鸣[3] 吕婉飞[2] 邓在春[3] 王翎[1] 

机构地区：[1]苏州大学附属第一医院老年医学科,江苏苏州215006 [2]宁波大学医学院附属医院微生物实验室,浙江宁波315020 [3]宁波大学医学院附属医院呼吸内科,浙江宁波315020

出　　处：《中华医院感染学杂志》2016年第22期5050-5052,共3页Chinese Journal of Nosocomiology

基　　金：宁波市自然科学基因(2016A610132);宁波市医学科技基金项目(2011B13)

摘　　要：目的调查三家医院31株泛耐药肺炎克雷伯菌(PDR-KPN)获得性耐药相关基因和可移动遗传元件遗传标记的存在状况,并分析其亲缘关系。方法收集三家医院2013年1月-12月分离31株PDR-KPN;采用聚合酶链反应(PCR)法检测β-内酰胺类、氨基糖苷类、喹诺酮类获得性耐药基因以及可移动遗传元件标记基因。对全部耐药基因检测结果作样本聚类分析。结果 31株PDR-KPN每株均检出β-内酰胺类、氨基糖苷类药物获得性耐药基因,喹诺酮类药物作用靶位gyrA基因突变阳性率100%;31株blaKPC与ISKpn6均阳性,blaKPC-ISKpn6连锁检测阳性率100.0%。样本聚类分析显示A、B、C三家医院的菌株分为三个簇群。B医院与C医院的菌株有较近的亲缘关系。结论本组菌株携带获得性耐药相关基因导致对相关抗菌药物耐药。指标聚类分析提示菌株之间存在克隆传播。OBJECTIVE To investigate the acquired resistance‐related genes and mobile genetic elements in 31 strains of pandrug‐resistant K lebsiella pneumoniae isolated from three hospitals and analyze the genetic relation‐ship .METHODS A total of 31 strains of pandrug‐resistant K .pneumoniae were isolated from three hospitals from Jan 2013 to Dec 2013 .The acquiredβ‐lactams ,aminoglycosides ,quinolones resistance genes and mobile genetic el‐ement marker genes were detected by using polymerase‐chain‐reaction （PCR） .RESULTS The acquiredβ‐lactams , aminoglycosides resistance genes were detected in each of the 31 strains of pandrug‐resistant K .pneumoniae .The positive rate of mutation of the quinolones target gyrA gene was 100% .Both blaK PC and ISK pn6 were tested positive in the 31 strains ,the positive rate of chain detection of the blaK PC‐ISK pn6 was 100 .0% .The sample cluster analysis indicated that the strains isolated from the hospital A ,B ,and C could be divided into three clus‐ters .The strains isolated from the hospital B showed close genetic relationship with the strains isolated from the hospital C .CONCLUSION The acquired resistance‐related genes that are carried by the strains lead to the resistance to related drugs .The index cluster analysis indicates that there is clone spread among the strains .

关 键 词：泛耐药 肺炎克雷伯菌 获得性耐药基因 可移动遗传元件 样本聚类分析 

分 类 号：R378.996[医药卫生—病原生物学]