CAJ | 학술논문

目的分析宁波大学医学院附属医院克雷伯菌属的耐药性及其对喹喏酮类药物的耐药机制.方法收集2009年10月-2011年3月分离出的20株克雷伯菌属菌株,经鉴定确认18株为肺炎克雷伯菌,2株为植生克雷伯菌.采用K-B纸片扩散法检测其对药物的敏感性.PCR法检测染色体介导的gyrA、parC基因和质粒介导的aac(6’)-Ⅰ b-Cr、qnrA、qnrB、qnrS、qepA基因,PCR阳性产物采用PCR直接全自动荧光法测序.结果 20株克雷伯菌属菌对β-内酰胺类、氨基糖苷类、喹诺酮类抗菌药物均表现为多重耐药性(耐药率均在80％以上),其中植生克雷伯菌对亚胺培南和美罗培南敏感.18株(90％)菌株存在gyrA、parC基因突变；aac(6’)-Ⅰ b-cr阳性12株(60％),qnrB和qnrS阳性均为4株(20％).结论本组20株克雷伯菌属菌对喹诺酮类药物耐药主要与gyrA和parC基因突变相关.
목적 분석저파대학의학원부속의원극뢰백균속적내약성급기대규야동류약물적내약궤제.방법 수집2009년10월-2011년3월분리출적20주극뢰백균속균주,경감정학인18주위폐염극뢰백균,2주위식생극뢰백균.채용K-B지편확산법검측기대약물적민감성.PCR법검측염색체개도적gyrA、parC기인화질립개도적aac(6’)-Ⅰ b-Cr、qnrA、qnrB、qnrS、qepA기인,PCR양성산물채용PCR직접전자동형광법측서.결과 20주극뢰백균속균대β-내선알류、안기당감류、규낙동류항균약물균표현위다중내약성(내약솔균재80％이상),기중식생극뢰백균대아알배남화미라배남민감.18주(90％)균주존재gyrA、parC기인돌변；aac(6’)-Ⅰ b-cr양성12주(60％),qnrB화qnrS양성균위4주(20％).결론 본조20주극뢰백균속균대규낙동류약물내약주요여gyrA화parC기인돌변상관.
Objective To investigate the multi-drug resistance of Klebsiella strains and its mechanism.Methods Twenty strains of Klebsiella were isolated from the Affiliated Hospital of Medical College,Ningbo University from October 2009 to March 2011,in which 18 isolates were Klebsiella pneumonia and 2 were Klebsiella planticola. Drug sensitivity was determined by K-B tests. Drug resistant genes gyrA,parC (chromosome mediated) and aac( 6′)-I b-Cr,qnrA,qnrB,qnrS,qepA (plasmid mediated) were amplified by PCR and verified by direct automated fluorogenic sequencing. Results Resistance to β-1actams,aminoglycosides and quinolones was observed in 20 strains,and resistant rates were all above 80％.Klebsiella planticola strains were sensitive to imipenem and meropenem.Mutations of gyrA and parC genes existed in 18 strains (90％),and the positive rates of aac (6') -I b-C r,qnrB and qnrS were 60％ (12/20),20％ (4/20) and 20％ (4/20),respectively.Conclusion The mutations ofgyrA and parC genes may be the main cause of the resistance to quinolones in these strains.