尿液标本分离的奇异变形杆菌质粒介导喹诺酮类耐药基因的研究  

Mechanisms of plasmid-mediated quinolone resistance in Proteus mirabilis from urine

作　　者：梁彩倩[1] 孔庆磊[1] 符永玫[1] 冯亚群[1] 杨晓燕[1] 

机构地区：[1]中山大学附属第三医院急诊科,广州市510630

出　　处：《实用医学杂志》2017年第24期4152-4155,共4页The Journal of Practical Medicine

基　　金：广东省医学科研基金项目(编号:A2015489)

摘　　要：目的调查临床尿液标本中分离的奇异变形杆菌质粒介导喹诺酮类耐药(PMQR)基因的分布情况。方法采用微量肉汤稀释法测定菌株对环丙沙星和左氧氟沙星的药物敏感性,应用PCR方法扩增PMQR基因qnrA、qnrB、qnrC、qnrD、qnrS、aac(6′)-Ib-cr和qep A,并对PCR阳性产物进行测序分析以确定基因亚型。结果 41株尿液标本分离的奇异变形杆菌对环丙沙星和左氧氟沙星的耐药率分别为41.5%和29.3%;检测到2株qnrA基因、3株qnrB基因,经测序证实为qnrA1和qnrB2亚型。未检测到qnrC、qnrD、qnrS、aac(6′)-Ib-cr和qep A基因。结论 PMQR基因存在于临床尿液标本分离的奇异变形杆菌中,主要基因型为qnrA1和qnrB2,介导细菌对喹诺酮类低水平耐药。Objective To investigate the prevalence of plasmid-mediated quinolone resistance（PMQR） in Proteus mirabilis clinical isolated from urine. Methods Antimicrobial susceptibility test was performed using the microdilution method.And PMQR gene qnrA,qnrB,qnrC,qnrD,qnrS,aac（6′）-Ib-cr,qepA were amplified by PCR,then the PCR positive products were sequenced to identify their genotypes. Results In 41 strains of Proteus mirabilis from urine,the resistant rates to ciprofloxacin and levofloxacin were 41.5% and 29.3%,respec-tively.Among all clinical isolates,qnrA1 gene was detected in 2 strains,qnrB2 gene in 3 strains.PMQR gene qn-rB,qnrC,qnrD,qnrS,aac（6＇）-Ib-cr and qepA were not detected in all strains.Conclusions Clinical isolates of Proteus mirabilis from urine carry PMQR genes.The prevalent principal genotypes are qnrA1 and qnrB2 in these iso-lates.They are related to low levels resistance toquinolone.

关 键 词：奇异变形杆菌 质粒 喹诺酮类 耐药机制 基因 

分 类 号：R446.12[医药卫生—诊断学]