K1和K2血清型肺炎克雷伯菌耐药性与可移动遗传元件研究  

Study on drug resistance and mobile genetic elements of Klebsiella pneumoniae of K1 and K2 serotypes

作　　者：杜芳玲 龙丹[1] 魏丹丹[1] 梅艳芳[1] 万腊根[1] 刘洋[1] DU Fang-ling;LONG Dan;WEI Dan-dan;MEI Yan-fang;WAN La-gen;LIU Yang(The First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi 330006, China)

机构地区：[1]南昌大学第一附属医院检验科,江西南昌330006

出　　处：《中华医院感染学杂志》2019年第8期1127-1130,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81560323);江西省教育厅青年基金资助项目(GJJ160233);江西省卫生计生委科技计划基金资助项目(20155140);江西省科技厅青年基金资助项目(20151BAB215028)

摘　　要：目的分析K1型肺炎克雷伯菌和K2型肺炎克雷伯菌的耐药基因和可移动遗传元件的分布。方法收集南昌大学第一附属医院2015年1月-2017年12月分离735株非重复肺炎克雷伯菌作为实验菌株,筛选出63株K1型肺炎克雷伯菌和29株K2型肺炎克雷伯菌,进行药物敏感性分析,PCR检测13种耐药基因和13种可移动遗传元件标记。结果 K1、K2血清型肺炎克雷伯菌对头孢唑林和头孢曲松耐药率较高,>20%,对其他抗菌药物都表现较高的敏感性,但出现耐碳青霉烯类药物的肺炎克雷伯菌;K1、K2血清型肺炎克雷伯菌acc6-Ib-cr和qnrS携带率较高,对其他耐药基因的携带率较低,但出现2株K1型和2株K2型携带KPC基因;除厄他培南和SHV基因外,K1型和K2型肺炎克雷伯菌对其它抗菌药物的耐药率和耐药基因的携带率差异无统计学意义,但K1型肺炎克雷伯菌对大部分抗菌药物的耐药率和耐药基因的携带率均低于K2型肺炎克雷伯菌;可移动遗传元件检出1种接合性质粒标记基因,1种整合子标记基因,4种插入序列标记基因,以traC基因和intI1基因阳性率最高。结论 K1、K2血清型肺炎克雷伯菌对大部分抗菌药物敏感性较高,耐药基因阳性率低,可移动遗传元件携带率较低;K1型和K2型高毒力肺炎克雷伯菌耐药表型的出现可能与携带可移动遗传元件相关。OBJECTIVE To understand the distribution of drug resistance genes and mobile genetic elements of 63 K. pneumonia strains of K1 serotype and 29 K. pneumonia strains of K2 serotype. METHODS A total of 735 strains of non-repetitive K. pneumoniae isolated from the First Affiliated Hospital of Nanchang University during Jan. 2015 to Dec. 2017 were collected, from which 63 K. pneumonia strains of K1 serotype and 29 K. pneumonia strains of K2 serotype were screened. The strains were identified by using Vitek2-compact automatic microorganisms analysis system, and the drug susceptibility was analyzed. All the isolates were assessed for 13 drug resistance genes and 13 mobile genetic elements by PCR. RESULTS K. pneumoniae of K1 and K2 serotypes had high resistance rates (up to 20%) to cefazolin and ceftriaxone, and had relatively high sensitivity to other antibacterial drugs. But carbapenem-resistant K pneumonia appeared. The detection rates of accG-Ib-cr gene and qnrS gene were relatively high. whereas the detection rates of other drug resistance genes were relatively low in K. pneumoniae of K1 and K2 serotypes, but 2 strains each of K1- and K2-serotype K. pneumoniae carried KPC gene. Except for ertapenem and SHV gene, K1 and K2 K pneumoniae had no significant difference in antibiotic resistance rate and drug resistance gene carrying rate. But the resistance rate of most antibacterial drugs and the carrying rate of the drug resistance genes of K1-serotype K. pneumoniae were lower than thoset of K2-serotype K pneumonia. In mobile genetic elements, one kind of conjugative plasmid marker gene, one kind of integron gene and four kinds of insertion sequence genes were detected by PCR. The mobile genetic elements with the highest positive rate were traC gene and inti 1 gene. CONCLUSION K1- and K2- serotype K. pneumoniae have high sensitivity to most antibacterial drugs, with low detection rates of drug resistance gene and low carrying rates of mobile genetic elements. The occurrence of drug resistance phenotypes of K1- and K2-se

关 键 词：肺炎克雷伯菌 耐药 可移动遗传元件 

分 类 号：R378.996[医药卫生—病原生物学]