肺炎克雷伯菌整合子携带情况及与毒力基因和耐药性的关系  

Integron carrier of Klebsiella pneumoniae and its correlation with virulence genes and drug resistance

作　　者：宋国滨 王刚[2] 黄颖[2] 吴文娟[1] 徐元宏[2] SONG Guo-bin;WANG Gang;HUANG Ying;WU Wen-juan;XU Yuan-hong(Shanghai East Hospital,Tongji University School of Medicine,Shanghai 200123,China;不详)

机构地区：[1]同济大学附属东方医院检验科,上海200123 [2]安徽医科大学第一附属医院检验科,安徽合肥230022

出　　处：《中华医院感染学杂志》2021年第3期321-325,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81171606)。

摘　　要：目的分析安徽医科大学第一附属医院临床分离肺炎克雷伯菌的耐药性,毒力基因、整合子携带情况,并重点比较分析整合子阳性和阴性菌株之间耐药性和毒力基因的差异性,探讨整合子在菌株耐药性以及整合毒力基因中的作用。方法收集临床分离保存的肺炎克雷伯菌72株,运用纸片扩散法和Vitek-2 compact仪器进行药物敏感性试验,聚合酶链式反应(PCR)技术扩增整合子基因(IntI1、IntI2、IntI3)、毒力基因(rmpA、aerobactin、alls、kfu、wcaG、magA、fimH、mrkD)。同时分析整合子阳性肺炎克雷伯菌和整合子阴性肺炎克雷伯菌之间毒力基因和耐药性的差异性。结果药敏试验结果表明72株肺炎克雷伯菌除对米诺还素、多黏菌素B、替加环素具有较高的敏感性外,对头孢菌素类、碳青霉烯类、喹诺酮类、氨基糖苷类抗菌药物耐药率均>30%,PCR技术检出整合子IntI1型共40株,未检出IntI2、IntI3型。毒力基因aerobactin、rmpA、wcaG、alls、kfu、fimH、mrkD、magA检出率分别为25.00%、44.44%、23.61%、19.44%、40.28%、98.61%、98.61%、12.50%。整合子阳性菌株和阴性菌株相比,对头孢菌素类,氨基糖苷类、喹诺酮类抗菌药物具有较高的耐药性,且差异有统计学意义(P<0.05)。但是整合子阳性菌株和整合子阴性菌株毒力基因携带情况相比,除aerobactin及kfu基因具有统计学差异外,其他六种毒力基因在两者之间无统计学意义。结论医院肺炎克雷伯菌以携带整合子IntI1型为主,整合子阳性菌株对头孢菌素类,氨基糖苷类、喹诺酮类抗菌药物耐药性更高,但对毒力基因的携带情况无差异。OBJECTIVE To analyze the drug resistance, virulence genes and integron carrying status of Klebsiella pneumoniae isolated from the First Affiliated Hospital of Anhui Medical University, and to compare the difference of drug resistance and virulence genes between integron-positive and negative strains, and to explore the role of integron in drug resistance and integration virulence genes. METHODS Totally 72 strains of K. pneumoniae from clinicals isolates were collected and preserved. The disc diffusion method and VITEK-2 compact instrument method were used for drug sensitivity test, and polymerase chain reaction(PCR) technology was used to amplify integron genes(IntI1, IntI2, IntI3) and virulence genes(rmpA, aerobatin, alls, kfu, wcaG, magA, fimH, mrkD). The difference in virulence genes and drug resistance between integron-positive K. pneumoniae and integron-negative K. pneumoniae were analyzed. RESULTS The results of drug sensitivity test showed that 72 strains of K. pneumoniae had high sensitivity to minorexin, polymyxin B and tigecycline, and the drug resistance rates to cephalosporins, carbapenems, quinolones and aminoglycosides were all greater than 30%. A total of 40 strains of integron IntI1 were detected by PCR, but IntI2 and IntI3 were not detected. The detection rates of virulence genes aerobactin, rmpA, wcaG, alls, kfu, fimH, mrkD and magA were 25.00%, 44.44%, 23.61%, 19.44%, 40.28%, 98.61%, 98.61% and 12.50%, respectively. Compared with the integron-negative strains, the integron-positive strains had higher resistance to cephalosporins, aminoglycosides and quinolones, and the difference was significant(P<0.05). However, compared the virulence gene carrying situation between the integron-negative strains and integron-positive strains, the other six virulence genes were not significant, except for aerobactin and KFU genes which were significantly different. CONCLUSION The main carrier of hospital K. pneumoniae was integron IntI1 type. The integron-positive strains were more resistant to cephalosporins,

关 键 词：肺炎克雷伯菌 整合子 毒力基因 耐药性 

分 类 号：R378[医药卫生—病原生物学]