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
2011年
5期
278-283
,共6页
朱健铭%姜如金%吴康乐%马兆龙%孔海深%张嵘%吕火祥%黄支密%孙长贵
硃健銘%薑如金%吳康樂%馬兆龍%孔海深%張嶸%呂火祥%黃支密%孫長貴
주건명%강여금%오강악%마조룡%공해심%장영%려화상%황지밀%손장귀
克雷伯菌,肺炎%β-内酰胺酶基因%可移动遗传元件%指标聚类分析
剋雷伯菌,肺炎%β-內酰胺酶基因%可移動遺傳元件%指標聚類分析
극뢰백균,폐염%β-내선알매기인%가이동유전원건%지표취류분석
Klebsiella pneumoniae%β-lactamase genes%Mobile genetic dements%Index cluster analysis
目的 调查一组耐药肺炎克雷伯菌的β-内酰胺类药物耐药的遗传学背景和可移动遗传元件的存在情况,以及二者可能存在的关系.方法 收集2008年8月-2010年5月浙江省杭州市和湖州市6家医院共47株肺炎克雷伯菌,先采用改良Hodge试验检测产碳青霉烯酶表型确证试验,再采用聚合酶链反应(PCR)的方法检测A～D四类40种β-内酰胺酶基因与膜孔蛋白编码基因(ompK35、omp K36)和12种可移动遗传元件标记基因,最后对检测结果作指标聚类分析.结果 本组耐药肺炎克雷伯菌共检出改良Hodge试验阳性株35株,5种β-内酰胺酶基因,并发现KPC-2变异型( KPC-2-1ike,GenBank登录号:HQ258934),以及9种可移动遗传元件标记基因.耐药肺炎克雷伯菌的ompK35、ompK36膜孔蛋白编码基因经测序并与肺炎克雷伯菌敏感株比对均存在突变.指标聚类分析显示,KPC-2以及变异型与 ISKpn6高度相关联,TEM-1与ISEcpl、IS26、intI1、trbC、IS903相关联,CMY-2、OXA-30、DHA-1与tnpU、tnp513、trbC相关联.结论 携带5种β-内酰胺酶基因和ompK35、ompK36膜孔蛋白编码基因存在突变是本组肺炎克雷伯菌对β-内酰胺类药物耐药的主要原因.
目的 調查一組耐藥肺炎剋雷伯菌的β-內酰胺類藥物耐藥的遺傳學揹景和可移動遺傳元件的存在情況,以及二者可能存在的關繫.方法 收集2008年8月-2010年5月浙江省杭州市和湖州市6傢醫院共47株肺炎剋雷伯菌,先採用改良Hodge試驗檢測產碳青黴烯酶錶型確證試驗,再採用聚閤酶鏈反應(PCR)的方法檢測A～D四類40種β-內酰胺酶基因與膜孔蛋白編碼基因(ompK35、omp K36)和12種可移動遺傳元件標記基因,最後對檢測結果作指標聚類分析.結果 本組耐藥肺炎剋雷伯菌共檢齣改良Hodge試驗暘性株35株,5種β-內酰胺酶基因,併髮現KPC-2變異型( KPC-2-1ike,GenBank登錄號:HQ258934),以及9種可移動遺傳元件標記基因.耐藥肺炎剋雷伯菌的ompK35、ompK36膜孔蛋白編碼基因經測序併與肺炎剋雷伯菌敏感株比對均存在突變.指標聚類分析顯示,KPC-2以及變異型與 ISKpn6高度相關聯,TEM-1與ISEcpl、IS26、intI1、trbC、IS903相關聯,CMY-2、OXA-30、DHA-1與tnpU、tnp513、trbC相關聯.結論 攜帶5種β-內酰胺酶基因和ompK35、ompK36膜孔蛋白編碼基因存在突變是本組肺炎剋雷伯菌對β-內酰胺類藥物耐藥的主要原因.
목적 조사일조내약폐염극뢰백균적β-내선알류약물내약적유전학배경화가이동유전원건적존재정황,이급이자가능존재적관계.방법 수집2008년8월-2010년5월절강성항주시화호주시6가의원공47주폐염극뢰백균,선채용개량Hodge시험검측산탄청매희매표형학증시험,재채용취합매련반응(PCR)적방법검측A～D사류40충β-내선알매기인여막공단백편마기인(ompK35、omp K36)화12충가이동유전원건표기기인,최후대검측결과작지표취류분석.결과 본조내약폐염극뢰백균공검출개량Hodge시험양성주35주,5충β-내선알매기인,병발현KPC-2변이형( KPC-2-1ike,GenBank등록호:HQ258934),이급9충가이동유전원건표기기인.내약폐염극뢰백균적ompK35、ompK36막공단백편마기인경측서병여폐염극뢰백균민감주비대균존재돌변.지표취류분석현시,KPC-2이급변이형여 ISKpn6고도상관련,TEM-1여ISEcpl、IS26、intI1、trbC、IS903상관련,CMY-2、OXA-30、DHA-1여tnpU、tnp513、trbC상관련.결론 휴대5충β-내선알매기인화ompK35、ompK36막공단백편마기인존재돌변시본조폐염극뢰백균대β-내선알류약물내약적주요원인.
Objective To investigate correlation between drug-resistance related genes and mobile genetic elements of Klebsiella pneumoniae resistant to β-lactams. Methods Forty-seven strains of multidrug-resistant Klebsiella pneumoniae were collected from 6 hospitals in Hangzhou and Huzhou of Zhejiang province from August 2008 to May 2010.Modified Hodge test was performed to detect phenotypes of carbapenemases.Forty kinds of β-lactamases (class A-D),ompK35,ompK36,and 12 kinds of mobile genetic elements were detected by PCR,and the results were analyzed by index cluster.Results Thirty-five strains were positive in modified Hodge test,and 5 kinds of β-lactamases gene ( including KPC-2-like,GenBank:HQ258934) and 9 kinds of mobile genetic elements were detected.Mutations were observed in ompK35 and ompK36 when compared with sensitive strains.Index cluster analysis showed that correlation existed between KPC-2,KPC-2-like and ISKpn6,between TEM-1 and ISEcpl,IS26,int Ⅰ 1,trbC,IS903,and between CMY-2,OXA-30,DHA-1 and tnpU,tnp513,trbC.Conclusions Five kinds of β-1actamases genes,and mutations in ompK35 and ompK36 may be associated with the resistance to β-1actams in multidrug-resistant Klebsiella pneumoniae.
