肠杆菌科细菌对氨基糖苷类的耐药性及 16S rRNA 甲基 化酶基因的检测研究  

Aminoglycoside resistance and the prevalence of 16S rRNA methylase genes in Enterobacteriaceae strains

作　　者：王文 王亮 陶佳 李刚 贾伟 WANG Wen;WANG Liang;TAO Jia;LI Gang;JIA Wei(Medical Experimental Center,General Hospital ofNingxia University,Ningxia Clinical Key Laboratory of Pathogenic Microorganisms,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院医学实验中心,宁夏临床病原微生物重点实验室,银川750004

出　　处：《中国感染与化疗杂志》2021年第5期593-598,共6页Chinese Journal of Infection and Chemotherapy

基　　金：宁夏自然科学基金(2021AAC03338)。

摘　　要：目的了解氨基糖苷类耐药肠杆菌科细菌的分布、耐药情况,及16S rRNA甲基化酶基因型的分布,为临床用药提供参考依据。方法收集宁夏医科大学总医院2017年临床分离的非重复肠杆菌科细菌142株,细菌鉴定采用VITEK-2 Compact系统,药敏试验采用肉汤微量稀释法,PCR扩增16S rRNA甲基化酶基因(armA、rmtA、rmtB、rmtC、rmtD、rmtE、rmtF、rmtG、rmtH、npmA)。结果142株肠杆菌科细菌中72株对氨基糖苷类耐药。这72株菌对头孢菌素类、氟喹诺酮类、氨曲南的耐药率均≥77.1%,对酶抑制剂复合制剂头孢哌酮-舒巴坦、哌拉西林-他唑巴坦的耐药率≥51.4%,对头孢他啶-阿维巴坦、替加环素的耐药率<10%,对碳青霉烯类耐药率≤40.0%。氨基糖苷类敏感株对多数抗菌药物的耐药率低于氨基糖苷类耐药株。氨基糖苷类耐药株中有71株检出16S rRNA甲基化酶基因,总阳性率为50.0%(71/142),在氨基糖苷类耐药株中的阳性率为98.6%(71/72)。71株中rmtB 54株,占76.1%;armA 14株,占19.7%;rmtA 2株,占2.8%;rmtB+armA 1株,占1.4%。未检出rmtC、rmtD、rmtE、rmtF、rmtG、rmtH和npmA基因。结论rmtB和armA 16S rRNA甲基化酶是该院临床分离肠杆菌科细菌对氨基糖苷类耐药的主要机制。Objective To investigate the distribution,resistance profile,and the prevalence of 16S rRNA methylase genes in Enterobacteriaceae strains in the General Hospital of Ningxia University for better clinical medication.Methods A total of 142 nonduplicate clinical isolates of Enterobacteriaceae were collected in 2017.Bacterial identification was performed by using VITEK-2 Compact system.The antimicrobial susceptibility testing was conducted by the broth microdilution method.The 16S rRNA methylase genes(armA,rmtA,rmtB,rmtC,rmtD,rmtE,rmtF,rmtG,rmtH,npmA)were assayed by PCR amplification.Results Overall,72 of the 142 strains of Enterobacteriaceae were aminoglycoside-resistant.Of the 72 strains of aminoglycoside-resistant Enterobacteriaceae,≥77.1%were resistant to cephalosporins,fluoroquinolones,and aztreonam;≥51.4%were resistant to cefoperazone-sulbactam and piperacillin-tazobactam;but<10%were resistant to ceftazidime-avibactam and tigecycline;≤40.0%were resistant to carbapenems.The aminoglycoside-sensitive strains showed lower resistance rates to most antimicrobial agents than aminoglycoside-resistant strains.The overall prevalence of 16S rRNA methylase genes was 50.0%(71/142),but 98.6%(71/72)in the aminoglycoside-resistant strains.Specifically,the prevalence of rmtB gene was 76.1%(54/71),followed by armA gene(19.7%,14/71),rmtA gene(2.8%,2/71),and rmtB and armA genes(1 strain,1.4%).The rmtC,rmtD,rmtE,rmtF,rmtG,rmtH,or npmA gene was not detected.Conclusions Production of rmtB and armA 16S rRNA methylase genes is the main mechanism of aminoglycoside resistance in Enterobacteriaceae strains.

关 键 词：氨基糖苷类耐药 肠杆菌科细菌 耐药基因 16S rRNA甲基化酶 

分 类 号：R378.2[医药卫生—病原生物学]