CAJ | 학술논문

目的研究氨基糖苷乙酰胺转移酶基因的突变形式aac(6’) -Ib -cr在肺炎克雷伯菌和大肠埃希菌临床株中的分布状况；分析携带该基因菌株对环丙沙星、氨基糖苷类和头孢菌素类的耐药特征.方法利用多聚酶链式反应检测肺炎克雷伯菌和大肠埃希菌临床分离株中aac(6’)-Ib基因携带情况,采用BtsC I酶切消化,经DNA测序确认aac(6 ’)-Ib-cr基因；统计分析aac(6’) -Ib-cr基因与环丙沙星、头孢菌素类和氨基糖苷类耐药性关系.结果 aac(6’)-Ib-cr基因在肺炎克雷伯菌和大肠埃希菌的检出率分别为12.6％ (30/238)和18.8％ (13/69)；aac(6 ’)-Ib-cr阳性株与阴性株对环丙沙星的耐药率分别为72.1％ (31/43)和48.1％(127/264),差异有统计学意义(X2=8.52,P＜0.05).肺炎克雷伯菌aac(6’)-Ib-cr基因阳性株对阿米卡星的耐药率高于aac(6’) -Ib-cr基因阴性株(X2=4.25,P＜0.05).aac(6’)- Ib-cr基因阳性株和阴性株对庆大霉素的耐药率、常用的头孢菌素类的耐药率和多重耐药率均较高,无统计学差异.结论本地区肺炎克雷伯菌和大肠埃希菌临床分离株中,aac(6’) -Ib-cr基因均有检出；aac(6’)-Ib-cr基因阳性株对环丙沙星耐药率明显高于阴性株,肺炎克雷伯菌中aac(6’)-Ib-cr基因阳性株对阿米卡星的耐药率明显高于阴性株,具有统计学意义.aac(6’) - Ib-cr基因阳性株和阴性株对常用头孢菌素类的耐药率和多重耐药率均较高,无统计学意义.
목적 연구안기당감을선알전이매기인적돌변형식aac(6’) -Ib -cr재폐염극뢰백균화대장애희균림상주중적분포상황；분석휴대해기인균주대배병사성、안기당감류화두포균소류적내약특정.방법 이용다취매련식반응검측폐염극뢰백균화대장애희균림상분리주중aac(6’)-Ib기인휴대정황,채용BtsC I매절소화,경DNA측서학인aac(6 ’)-Ib-cr기인；통계분석aac(6’) -Ib-cr기인여배병사성、두포균소류화안기당감류내약성관계.결과 aac(6’)-Ib-cr기인재폐염극뢰백균화대장애희균적검출솔분별위12.6％ (30/238)화18.8％ (13/69)；aac(6 ’)-Ib-cr양성주여음성주대배병사성적내약솔분별위72.1％ (31/43)화48.1％(127/264),차이유통계학의의(X2=8.52,P＜0.05).폐염극뢰백균aac(6’)-Ib-cr기인양성주대아미잡성적내약솔고우aac(6’) -Ib-cr기인음성주(X2=4.25,P＜0.05).aac(6’)- Ib-cr기인양성주화음성주대경대매소적내약솔、상용적두포균소류적내약솔화다중내약솔균교고,무통계학차이.결론 본지구폐염극뢰백균화대장애희균림상분리주중,aac(6’) -Ib-cr기인균유검출；aac(6’)-Ib-cr기인양성주대배병사성내약솔명현고우음성주,폐염극뢰백균중aac(6’)-Ib-cr기인양성주대아미잡성적내약솔명현고우음성주,구유통계학의의.aac(6’) - Ib-cr기인양성주화음성주대상용두포균소류적내약솔화다중내약솔균교고,무통계학의의.
Objective To investigate the prevalence of aac (6')-Ib-cr gene in clinical isolates of Klebsiella pneumoniae and Escherichia coli,and analyze the drug-resitant charactcristios of positive aac ( 6' ) - ib- cr isolates of fluoroquinolones,aminoglyeosides and cephalosporins.Methods aac ( 6' ) -Ib gene were detected by PCR.Positive PCR products of aac(6')-Ib were digested with BtsCI and sequencing to identify aac(6')-Ib-cr; analyze the resistance to fluoroquinolones,aminoglycosides and cephalosporins in isolates containig aac( 6 ' ) -Ib-cr gene with statistical methods.Results aac( 6' ) -Ib -cr gene was detected in 12.6 ％ ( 3 0 / 2 3 8 ) of Klebsiella pneumoniae isolates and 18.8 ％ ( 1 3 / 6 9 ) of Escherichia coli isolates; the resistance rates of ciprofloxacin in positive and negative aac (6')-Ib-cr isolates were 72.1％ (31/43) and 48.1％ (127/264),the difference was statistically significant (x2 =8.52,P ＜ 0.05 ).The resistance rate of amikacin in positive aac ( 6' ) -Ib-cr of Klebsiella pneumoniae isolates was significantly higher than negative isolates(x2 =4.25,P ＜ 0.05 ).All the isolates displayed a high resistant rate to gentamicin and cephalosporins which else showed multidrug resistance,regardless the carrying of aac (6')-Ib-cr gene,which showed no significant difference.Conclusion In the region,aac (6')-Ib-cr gene was both detected in Klebsiella pneumoniae and Escherichia coli clinical isolates; The resistance rate to ciprofloxacin in positive aac (6')-Ib-cr isolates was significantly higher than negative isolates,so did to amikacin in Klebsiella pneumonia isolates,which had statistical significance,the resistance rate and the multiple resistance rate of common used cephalosporins in whether positive or negative aac(6')-Ib-cr isolates were high,which has no statistically significant.