中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2008年
1期
38-42
,共5页
钱英%蒋琰%周志慧%俞云松%魏泽庆%沈萍%李兰娟
錢英%蔣琰%週誌慧%俞雲鬆%魏澤慶%瀋萍%李蘭娟
전영%장염%주지혜%유운송%위택경%침평%리란연
喹诺酮类%超广谱β-内酰胺酶%qnrA%质粒
喹諾酮類%超廣譜β-內酰胺酶%qnrA%質粒
규낙동류%초엄보β-내선알매%qnrA%질립
Quinolones%Extended-spectrum beta-lactamases%qnrA gene%Plasmid
目的 明确产超广谱β-内酰胺酶(ESBLs)菌株对喹诺酮类药物的耐药机制.方法 用PCR方法扩增产ESBLs的263株大肠埃希菌和99株肺炎克雷伯菌的qnrA基因.对CTX-M和qnrA基因都阳性的肺炎克雷伯菌ZJ96采用接合试验、Southern杂交进行基因定位,用鸟枪法对分离自ZJ96菌株的同时含qnrA和CTX-M基因的质粒(pKP96)进行全序列测定.结果 263株大肠埃希菌中有5株检出qnrA基因,阳性率为1.9%;99株肺炎克雷伯菌中有8株检出qnrA基因,阳性率为8.1%.ZJ96菌株含有CTX-M和qnrA基因同时阳性的大小约60 kb的接合性质粒pKP96.菌株ZJ96的接合菌质粒pKP96含有qnrA、CTX-M-24、aac(6')-Ib-cr、tetA和intⅠ 1等基因.结论 喹诺酮耐药基因qnrA和CTX-M-24型ESBLs基因同时位于可接合性质粒中,耐药质粒的广泛传播是造成临床耐药菌株大量出现的主要原因.
目的 明確產超廣譜β-內酰胺酶(ESBLs)菌株對喹諾酮類藥物的耐藥機製.方法 用PCR方法擴增產ESBLs的263株大腸埃希菌和99株肺炎剋雷伯菌的qnrA基因.對CTX-M和qnrA基因都暘性的肺炎剋雷伯菌ZJ96採用接閤試驗、Southern雜交進行基因定位,用鳥鎗法對分離自ZJ96菌株的同時含qnrA和CTX-M基因的質粒(pKP96)進行全序列測定.結果 263株大腸埃希菌中有5株檢齣qnrA基因,暘性率為1.9%;99株肺炎剋雷伯菌中有8株檢齣qnrA基因,暘性率為8.1%.ZJ96菌株含有CTX-M和qnrA基因同時暘性的大小約60 kb的接閤性質粒pKP96.菌株ZJ96的接閤菌質粒pKP96含有qnrA、CTX-M-24、aac(6')-Ib-cr、tetA和intⅠ 1等基因.結論 喹諾酮耐藥基因qnrA和CTX-M-24型ESBLs基因同時位于可接閤性質粒中,耐藥質粒的廣汎傳播是造成臨床耐藥菌株大量齣現的主要原因.
목적 명학산초엄보β-내선알매(ESBLs)균주대규낙동류약물적내약궤제.방법 용PCR방법확증산ESBLs적263주대장애희균화99주폐염극뢰백균적qnrA기인.대CTX-M화qnrA기인도양성적폐염극뢰백균ZJ96채용접합시험、Southern잡교진행기인정위,용조창법대분리자ZJ96균주적동시함qnrA화CTX-M기인적질립(pKP96)진행전서렬측정.결과 263주대장애희균중유5주검출qnrA기인,양성솔위1.9%;99주폐염극뢰백균중유8주검출qnrA기인,양성솔위8.1%.ZJ96균주함유CTX-M화qnrA기인동시양성적대소약60 kb적접합성질립pKP96.균주ZJ96적접합균질립pKP96함유qnrA、CTX-M-24、aac(6')-Ib-cr、tetA화intⅠ 1등기인.결론 규낙동내약기인qnrA화CTX-M-24형ESBLs기인동시위우가접합성질립중,내약질립적엄범전파시조성림상내약균주대량출현적주요원인.
Objective To characterize the prevalence of plasmid-mediated quinolone resistance determinants qnrA in extended-spectrum β-lactamase(ESBL)-producing Escherichia coli and Klebsiella pneumonia.Methods PCR was used to amplify qnrA gene in ESBL-rpoducing isolates(including 263isolates of Escherichia coli and 99 isolates of Klebsiella pneumonia).Conjugation experiments and southern blot hybridization were employed to definitude the location of the genes in ZJ96 isolate of Klebsiella pneumonia which had positive qnrA and CTX-M genes.Shot gun sequencing was performed for analyzing the complete nucleotide sequence of pKP96,a plasmid containing qnrA and CTX-M-24 genes in ZJ96 isolate.Results qnrA was detected in 5 out of 263(1.9%)Escherichia coli isolates and 8 out of 99(8.1%)Klebsiella pneumonia isolates.pKP96,a conjugative plasmid including qnrA gene and CTX-M-24 gene presented in ZJ96 isolate.The sequence of the plasmid pKP96 displayed the qnrA,CTX-M-24,aac(6')-Ib-cr,tetA and int Ⅰ 1 genes.Conclusion The plasmid-mediated genes,such as qnrA and CTX-M,may facilitate the prevalence of multi-drug resistant strains.
