ICU产肺炎克雷伯菌喹诺酮类药物耐药相关基因研究  

Study on genes related to quinolone drug resistance of Klebsiella pneumoniae in ICU

作　　者：陈国忠 俞燕红 应建飞 鲁勇 汪一萍 周成杰 CHEN Guo-zhong;YU Yan-hong;YING Jian-fei;LU Yong;WANG Yi-ping;ZHOU Cheng-jie(Department of Intensive Care Unit,Yinzhou People's Hospital,Ningbo,Zhejiang 315040,China;不详)

机构地区：[1]宁波市鄞州人民医院ICU,浙江宁波315040 [2]宁波市鄞州人民医院检验科,浙江宁波315040

出　　处：《中国卫生检验杂志》2021年第13期1564-1566,共3页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生科技计划项目(2018ky753)。

摘　　要：目的研究ICU产肺炎克雷伯菌喹诺酮类药物耐药相关基因分布情况。方法回顾性研究2018年4月—2019年12月临床分离产自ICU非重复肺炎克雷伯菌44株,检测相关喹诺酮类药物耐药基因。经PCR筛查质粒介导喹诺酮耐药基因qnrA、qnrB、qnrS、aac(6′)-Ib-cr、外排泵基因qepA以及gyrA基因突变。结果44株菌株中qnrA、qnrB基因均未检出,32株细菌检出了qnrS基因,阳性率为72.7%;11株细菌检出了aac(6′)-Ib-cr,阳性率为25.0%。仅4株qepA基因结果显示阳性,26株细菌存在gyrA基因的第83位密码子突变,阳性率为59.1%。所有菌株对左氧氟沙星的耐药率为54.5%;对环丙沙星的耐药率为61.4%。另对碳青霉烯类和头孢菌素类耐药率均达到了50.0%以上。结论ICU产菌株qnrS和aac(6′)-Ib-cr基因检出率较高,gyrA基因突变主要位于83位密码子,且具有较高耐药性。Objective To study the distribution of quinolone resistance related genes of Klebsiella pneumoniae in ICU.Methods Forty-four strains of K.pneumoniae isolated from ICU from April 2018 to December 2019 were collected.The plasmid-mediated quinolone resistance genes,including qnrA,qnrB,qnrS,aac-(6′)-Ib-cr,efflux pump gene qepA,and gyrA gene mutation were detected by PCR.Results qnrA and qnrB gene were not detected in 44 strains.The positive rate were 72.7%and 25.0%for qnrS gene and aac(6′)-Ib-cr gene,respectively.qepA gene was only positive in 4 strains.gyrA gene mutations in 83 codon of gyrA gene was found in 26 strains of bacteria,and the positive rate was 59.1%.The drug resistance rates of polylevofloxacin,ciprofloxacin were 54.5%and 61.4%,respectively.In addition,the drug resistance rate of carbapenems and cephalosporin was over 50.0%.Conclusion The detection rate of qnrS and aac(6′)-Ib-cr genes from ICU strains was high,and gyrA gene mutations are mainly located in 83 codon.

关 键 词：肺炎克雷伯菌 喹诺酮类 QNR aac-(6′)-Ib-cr QEPA GYRA 

分 类 号：R446.5[医药卫生—诊断学]