阴沟肠杆菌质粒介导耐药基因检测及同源性分析  

Detection of plasmid-mediated resistance genes in Enterobacter cloacae and analysis of homology

作　　者：李美[1,2] 刘宝[3] 万珊[3] 杨焕婕[3] 费樱[2,3] 

机构地区：[1]贵阳市第二人民医院检验科,贵州贵阳550081 [2]贵州医科大学医学检验学院医学检验系,贵州贵阳550004 [3]贵州医科大学附属医院微生物免疫科,贵州贵阳550001

出　　处：《中华医院感染学杂志》2016年第22期5060-5063,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科技厅基金资助项目(黔科合SY字[2012]3147);贵阳市科技局基金资助项目(筑科合同[20151001]社34)

摘　　要：目的了解质粒介导的超广谱β-内酰胺酶(ESBLs)、头孢菌素酶(AmpC)及喹诺酮类耐药(qnr)基因在阴沟肠杆菌中的分布,分析耐药阴沟肠杆菌株间的分子同源性,为指导临床有效控制耐药菌株在医院内的传播提供依据。方法收集2013年6月-2014年6月非重复阴沟肠杆菌174株,采用PCR法对其ESBLs基因(TEM-1、SHV-12、CTX-M-3、SFO-1、VEB-3)、AmpC酶基因(ACT-1、DHA-1)和qnr基因(qnrA、qnrB、qnrS)进行扩增;应用肠杆菌科重复一致序列(ERIC)方法对71株耐药菌株进行DNA分子同源性检测。结果 174株阴沟肠杆菌中β-内酰胺酶基因检出率57.47%,AmpC酶基因检出率22.41%,qnr基因检出率为27.01%;经χ2检验,环丙沙星耐药或敏感株对qnr基因阳性检出率比较差异有统计学意义(P<0.05),ESBLs+AmpC酶基因均阴性株与ESBLs、AmpC酶、ESBLs+AmpC酶基因均阳性株对qnr基因阳性检出率比较,差异有统计学意义(P<0.05)。结论阴沟肠杆菌中同时存在不同类型β-内酰胺酶基因和qnr基因,ESBLs耐药基因以TEM-1型为主;ESBLs或AmpC酶基因阳性株可同时携带qnr基因;阴沟肠杆菌在医院内存在部分克隆株散在传播情况。OBJECTIVE To understand the distribution of plasmid‐mediated extended spectrum beta‐lactamases （ESBLs） ,cephalosporinase （A mpC） ,and quinolones （qnr） resistance genes in Enterobacter cloacae and analyze the homology among the drug‐resistant E .cloacae strains so as to provide guidance for effective control of spread of the drug‐resistant strains .METHODS A total of 174 strains of non‐repetitive E .cloacae were collected from Jun 2013 to Jun 2014 .The ESBLs genes （TEM‐1 ,SHV‐12 ,CTX‐M‐3 ,SFO‐1 ,VEB‐3） ,AmpC genes （ACT‐1 , DHA‐1） ,and qnr genes （qnrA ,qnrB ,qnrS） were amplified by using PCR .The DNA homology was detected for 71 strains of drug‐resistant E .cloacae by means of Enterobacteriaceae repeat consensus sequences （ERCS ） . RESULTS Among the 174 strains of E .cloacae ,the detection rate ofβ‐lactamase genes was 57 .47% ,the detection rate of AmpC genes was 22 .41% ,and the detection rate of qnr genes was 27 .01% .The result of chi‐square test showed that there was significant difference in the positive rate of detection of qnr genes between the ciprofloxacin‐resistant strains and the ciprofloxacin‐sensitive strains （P〈0 .05） ,and there was significant difference in the posi‐tive rate of detection of qnr genes between the strains negative for ESBLs plus AmpC genes and the strains positive for ESBLs ,AmpC ,and ESBLs plus AmpC genes （P〈 0 .05） .CONCLUSION The E .cloacae strains carry with the ESBLs genes and qnr genes at the same time;the TEM‐1 is dominant among the ESBLs genes .The E .cloacae strains positive for the ESBLs or AmpC genes carry with the qnr genes .Some of clone strains of E .cloacae spread in the hospital .

关 键 词：阴沟肠杆菌 质粒 ESBLs基因 AMPC酶基因 QNR基因 

分 类 号：R378[医药卫生—病原生物学]