肺炎克雷伯菌外排泵基因与消毒剂和抗菌药物耐药相关性研究  

Correlation between efflux pump genes in Klebsiella pneumoniae and resistance to disinfectants and antibiotics

作　　者：金虹 王洪敏 武雪冰 张建中 苏裕心 JIN Hong;WANG Hong-min;WU Xue-bing;ZHANG Jian-zhong;SU Yu-xin(Center for Disease Control and Prevention of Chinese PLA,Beijing 100071;Shinva Medical Instrument Co.,Ltd.;Zhongguancun International Medical Inspection and Certification Technology Co.,Ltd.;Chongqing Liangjiang Chuangxiang Medical Inspection and Certification Co.,Ltd.,China)

机构地区：[1]中国人民解放军疾病预防控制中心,北京100071 [2]山东新华医疗器械股份有限公司 [3]中关村国际医药检验认证科技有限公司 [4]重庆两江创享医药检验认证科技有限公司

出　　处：《中国消毒学杂志》2022年第11期813-817,共5页Chinese Journal of Disinfection

基　　金：中华预防医学会消毒领域科研创新专项(2013 DX003)。

摘　　要：目的 研究肺炎克雷伯菌临床分离株对常用消毒剂和抗菌药物的敏感性及外排泵基因携带情况,分析抗性基因与消毒剂抗性和抗菌药物耐药性之间的相关性。方法 从不同地区医院的临床血液标本中分离肺炎克雷伯菌,筛查外排泵基因qacE△1、qacE、cepA和emrE携带情况。通过肉汤微量稀释法评估受试菌对消毒剂和抗菌药物的敏感性,分析目标基因与细菌对消毒剂和抗菌药物耐药性之间的相关性。结果 cepA基因是分布最广的外排泵基因,其次是qacE△1、emrE。部分菌株对氧氟沙星等抗菌药物耐药,而多数菌株对美罗培南敏感,所有受试菌株均对多黏菌素B敏感。92.3%携带cepA基因的菌株对醋酸氯己定抗性明显升高,其MIC≥8 mg/L,显著高于未携带cepA的菌株;61.9%携带qacE△1菌株具有多药耐药性,显著高于qacE△1阴性分离株。结论 肺炎克雷伯菌普遍携带cepA和qacE△1基因,携带cepA基因可能与其对醋酸氯己定敏感性降低有关,携带qacE△1基因可能与受试菌多药耐药表型高度相关。Objective To study the sensitivity of clinical isolates of Klebsiella pneumoniae to commonly used disinfectants and antibiotics and the carrying of efflux pump genes,and to analyze the correlation between resistance genes and disinfectant and antibiotic resistance.Methods Klebsiella pneumoniae was isolated from clinical blood samples from hospitals in different regions,and the carrier of efflux pump genes qacE△1,qacE,cepA and emrE were screened.The sensitivity of the tested bacteria to disinfectants and antibiotics was evaluated by broth microdilution method,and the correlation between the target gene and bacterial resistance to disinfectants and antibiotics was analyzed.Results cepA gene was the most widely distributed efflux pump gene,followed by qacE△1 and emrE.Some strains were resistant to ofloxacin and other antibiotics,while most strains were sensitive to meropenem,and all tested strains were sensitive to polymyxin B.92.3% of the strains carrying cepA gene were significantly more resistant to chlorhexidine acetate,with MIC ≥8 mg/L,which was significantly higher than that of the strains without cepA gene;and 61.9% of the strains carrying qacE△1 had multidrug resistance,which was significantly higher than that of qacE△1 negative isolates.Conclusion Klebsiella pneumoniae generally carry cepA and qacE△1 genes,which may be related to the decreased sensitivity to chlorhexidine acetate,and the carrying of qacE△1 gene may be highly related to the multidrug resistance phenotype of the tested bacteria.

关 键 词：肺炎克雷伯菌 消毒剂 抗菌药物 外排泵基因 多药耐药性 

分 类 号：R372[医药卫生—病原生物学]