阴沟肠杆菌分离株五类抗菌药物耐药基因元件分析  

Investigation of resistance genes to 5 kinds of antimicrobial agents in Enterobacter cloacae

作　　者：张卉[1] 徐燕 荆兆海 杨平玲 刘霞[3] 王彦[3] 周彦[3] ZHANG Hui;XU Yan;JING Zhao-hai;YANG Ping-ling;LIU Xia;WANG Yan;ZHOU Yan(People＇s Hospital of Rizhao,Rizhao,Shandong 276800,China)

机构地区：[1]日照市人民医院内分泌科,山东日照276800 [2]日照市中心医院检验科,山东日照276800 [3]连云港市第二人民医院检验科,江苏连云港222000

出　　处：《中华医院感染学杂志》2018年第19期2889-2892,2909,共5页Chinese Journal of Nosocomiology

基　　金：连云港市科技基金资助项目(SH1526)

摘　　要：目的调查一组20株阴沟肠杆菌中五类抗菌药物耐药基因元件的携带状况,及菌株间的亲缘关系。方法收集2014年1-12月医院患者痰标本中分离的20株阴沟肠杆菌,12种抗菌药物敏感性试验为K-B法。采用聚合酶链反应(PCR)及序列分析的方法分析20种β-内酰胺类耐药基因、17种氨基糖苷类耐药基因、5种喹诺酮类耐药基因、2种氯霉素耐药基因、4种磺胺类耐药基因、7种可移动遗传元件遗传标记。阳性耐药基因测序后直接作BLAST比对。耐药基因检测结果作样本聚类分析(UPGMA法)。结果 20株阴沟肠杆菌对β-内酰胺类药物除亚胺培南、美罗培南外均为耐药,对氨基糖苷类与磺胺类药物亦均为耐药。20株菌共检出4种β-内酰胺酶类耐药基因、6种氨基糖苷类耐药基因、3种喹诺酮类耐药基因、1种氯霉素耐药基因、4种磺胺类耐药基因、4种可移动遗传元件遗传标记,且阳性率较高。样本聚类分析显示:除13号菌株外的其余19株显聚集性。其中4～7号菌株,6～11号菌株,14～16号菌株均为克隆传播。本组菌检出的3个克隆可能为医院感染。结论本组20株阴沟肠杆菌携带的β-内酰胺类耐药基因、氨基糖苷类耐药基因、喹诺酮类耐药基因、氯霉素耐药基因、磺胺类耐药基因和可移动遗传元件遗传标记是对β-内酰胺类、氨基糖苷类、喹诺酮类、氯霉素、磺胺类产生耐药的重要原因。OBJECTIVE To investigate the distribution of resistance genes to 5 kinds of antimicrobial agents in Enterobacter cloacaeand to investigate phylogenetics of this group of E.cloacae.METHODS From Jan.to Dec.2014,20 strains of E.cloacae were collected from Rizhao,Shandong Province,China.K-B method was used to carry out the 12 kinds of drug sensitivity tests.20 kinds of beta-lactamase genes,17 resistance genes to aminoglycosides,5 resistance genes to quinolones,2 resistance genes to chloramphenicol,4 resistance genes to sulfanilamides,and 7 genetic markers of mobile genetic elements were analyzed by PCR.Positive resistance genes were verified by DNA sequencing and BLAST algorithm.Finally,resistance genes were used as molecular markers to perform sample cluster analysis（UPGMA）.RESULTS All 20 strains of E.cloacae were resistant to beta-lactams,except imipenem and meropenem,and resistant to aminoglycosides and sulfanilamide.4 beta-lactamase genes,6 resistance genes to aminoglycosides,3 resistance genes to quinolones,1 resistance gene to chloramphenicol,4 resistance genes to sulfanilamides,and 4 genetic markers of mobile genetic elements were positive in this group of E.cloacae,and the positive rates were high.Sample cluster analysis showed aggregation of 19 strains,except strain No.13,among which,strains No.4-7,6-11,14-16 were results of cloning propagation.3 clones in this group of E.cloacae were suspected nosocomial infection.CONCLUSIONResistance genes to beta-lactamas,aminoglycosideis,quinolones,chloramphenicol,sulfanilamides,and mobile genetic elements in a group of E.cloacae played a key role in resistance to beta-lactams,aminoglycosides,quinolones,chloramphenicol,and sulfanilamides.

关 键 词：阴沟肠杆菌 耐药基因 Β-内酰胺类 氨基糖苷类 磺胺类 可移动遗传元件 样本聚类分析 

分 类 号：R378[医药卫生—病原生物学]