携带blaKPC基因肺炎克雷伯菌的氨基糖苷类耐药元件研究  

Acquired aminoglycoside-resistant genes in Klebsiella pneumoniae carrying blaKPCgene

作　　者：张筠[1] 马红映[1] 汪丽[2] 常燕子 邓在春[1] 

机构地区：[1]宁波大学医学院附属医院呼吸科,浙江宁波315020 [2]宁波大学医学院附属医院细菌室,浙江宁波315020 [3]宁波市李惠利医院细菌室,浙江宁波315040

出　　处：《中华医院感染学杂志》2017年第21期4811-4814,共4页Chinese Journal of Nosocomiology

基　　金：宁波市自然科学基金资助项目(2016A610132)

摘　　要：目的调查宁波两家医院24株携带blaKPC基因耐碳青霉烯类抗菌药物肺炎克雷伯菌(CRKP)的氨基糖苷类耐药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。方法收集两家医院2016年1月-12月分离出的24株携带blaKPC基因的CRKP菌,采用聚合酶链反应(PCR)法检测氨基糖苷类及可移动遗传元件标记基因,将氨基糖苷类耐药元件检测结果作样本聚类分析。结果 20株菌rmtB和ant(3")-Ⅰ基因均阳性,1株菌仅rmtB基因阳性,接合性质粒标记traA、trbC检出率分别为91.7%和95.8%,插入序列IS26、IS903、ISEcp1检出率分别为87.5%、91.7%和87.5%,样本聚类分析显示菌株分为A与B二群,A群菌株有明显的聚集性。结论本组CRKP菌株携带氨基糖苷类获得性耐药相关基因导致对氨基糖苷类抗菌药物耐药,指标聚类分析提示菌株之间存在克隆传播。OBJECTIVE To investigate the distribution of acquired aminoglycoside-resistant genes and markers of mobile genetic elements in 24 strains of carbapenem-resistant Klebsiella pneumoniae（CRKP）carrying blaKPC gene in two hospitals in Ningbo,and analyze their relationships.METHODS Twenty-four strains of CRKP carrying blaKPCgene were isolated from Jan.2016 to Dec.2016 from two hospitals.Acquired aminoglycoside-resistant genes and genetic markers of mobile genetic elements were analyzed by PCR.The sample cluster analysis was used to investigate their relationships.RESULTS Acquired aminoglycoside-resistant genes rmtB and ant（3＂）-Ⅰwere coexistent in 20 strains,and rmtBgene was existent lonely in one strain.The detection rates of traA,trbC,IS26,IS903 and ISEcp1 were 91.7%,95.8%,87.5%,91.7% and 87.5%,respectively.The cluster analysis showed that the isolates were divided into two groups：group A and group B,and group A showed obvious aggregation.CONCLUSIONIn this group of CRKP,acquired aminoglycoside-resistant genes may be associated with resistance to aminoglycoside antibiotics.There were clone spread between strains.

关 键 词：碳青霉烯耐药 肺炎克雷伯菌 氨基糖苷类耐药基因 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]