中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2013年
9期
513-518
,共6页
邵宜波%李旭%胡立芬%谢琴秀
邵宜波%李旭%鬍立芬%謝琴秀
소의파%리욱%호립분%사금수
质粒%喹诺酮类%抗药性,细菌%聚合酶链反应%基因扩增%柠檬酸杆菌属
質粒%喹諾酮類%抗藥性,細菌%聚閤酶鏈反應%基因擴增%檸檬痠桿菌屬
질립%규낙동류%항약성,세균%취합매련반응%기인확증%저몽산간균속
Plasmids%Quinolones%Drug resistance,bacterial%Polymerase chain reaction%Gene amplification%Citrobacter
目的 了解枸橼酸杆菌中质粒介导喹诺酮耐药(PMQR)基因的分布,以期发现新型PMQR基因.测定临床分离的PMQR基因阳性枸橼酸杆菌对临床常用抗菌药物的敏感性.方法 收集安徽医科大学第一附属医院检验科2009年临床分离的枸橼酸杆菌,PCR扩增qnr、aac(6′)-Ib-cr和qepA基因,产物纯化测序,测序结果在GenBank上比对并行转移接合实验.对收集的PMQR基因阳性枸橼酸杆菌及其接合子,采用琼脂对倍稀释法进行临床常用抗菌药物的药物敏感试验.结果 收集的枸橼酸杆菌共31株,8株菌株扩增出qnr,qnr基因阳性率为25.8％；其中6株扩增出qnrB.4株qnr阳性菌株的qnr基因转移接合成功.在qnr阳性的枸橼酸杆菌中,测序发现1种PMQR基因新亚型,命名为qnrB24.所有qnr阳性临床菌株对喹诺酮类药物的耐药率为87.5％,对头孢噻肟、阿米卡星、头孢他啶、头孢吡肟和庆大霉素的耐药率分别为75.0％、7.5％、62.5％、37.5％和87.5％,所有qnr阳性菌株对亚胺培南耐药表型为敏感.喹诺酮类药物对qnr阳性的接合子最低抑菌浓度升高10～23倍,敏感性下降.结论 安徽地区枸橼酸杆菌中qnr基因型的检出率较高,以qnrB基因型为主,qnr阳性枸橼酸杆菌对常用抗菌药物耐药性较高.
目的 瞭解枸櫞痠桿菌中質粒介導喹諾酮耐藥(PMQR)基因的分佈,以期髮現新型PMQR基因.測定臨床分離的PMQR基因暘性枸櫞痠桿菌對臨床常用抗菌藥物的敏感性.方法 收集安徽醫科大學第一附屬醫院檢驗科2009年臨床分離的枸櫞痠桿菌,PCR擴增qnr、aac(6′)-Ib-cr和qepA基因,產物純化測序,測序結果在GenBank上比對併行轉移接閤實驗.對收集的PMQR基因暘性枸櫞痠桿菌及其接閤子,採用瓊脂對倍稀釋法進行臨床常用抗菌藥物的藥物敏感試驗.結果 收集的枸櫞痠桿菌共31株,8株菌株擴增齣qnr,qnr基因暘性率為25.8％；其中6株擴增齣qnrB.4株qnr暘性菌株的qnr基因轉移接閤成功.在qnr暘性的枸櫞痠桿菌中,測序髮現1種PMQR基因新亞型,命名為qnrB24.所有qnr暘性臨床菌株對喹諾酮類藥物的耐藥率為87.5％,對頭孢噻肟、阿米卡星、頭孢他啶、頭孢吡肟和慶大黴素的耐藥率分彆為75.0％、7.5％、62.5％、37.5％和87.5％,所有qnr暘性菌株對亞胺培南耐藥錶型為敏感.喹諾酮類藥物對qnr暘性的接閤子最低抑菌濃度升高10～23倍,敏感性下降.結論 安徽地區枸櫞痠桿菌中qnr基因型的檢齣率較高,以qnrB基因型為主,qnr暘性枸櫞痠桿菌對常用抗菌藥物耐藥性較高.
목적 료해구연산간균중질립개도규낙동내약(PMQR)기인적분포,이기발현신형PMQR기인.측정림상분리적PMQR기인양성구연산간균대림상상용항균약물적민감성.방법 수집안휘의과대학제일부속의원검험과2009년림상분리적구연산간균,PCR확증qnr、aac(6′)-Ib-cr화qepA기인,산물순화측서,측서결과재GenBank상비대병행전이접합실험.대수집적PMQR기인양성구연산간균급기접합자,채용경지대배희석법진행림상상용항균약물적약물민감시험.결과 수집적구연산간균공31주,8주균주확증출qnr,qnr기인양성솔위25.8％；기중6주확증출qnrB.4주qnr양성균주적qnr기인전이접합성공.재qnr양성적구연산간균중,측서발현1충PMQR기인신아형,명명위qnrB24.소유qnr양성림상균주대규낙동류약물적내약솔위87.5％,대두포새우、아미잡성、두포타정、두포필우화경대매소적내약솔분별위75.0％、7.5％、62.5％、37.5％화87.5％,소유qnr양성균주대아알배남내약표형위민감.규낙동류약물대qnr양성적접합자최저억균농도승고10～23배,민감성하강.결론 안휘지구구연산간균중qnr기인형적검출솔교고,이qnrB기인형위주,qnr양성구연산간균대상용항균약물내약성교고.
Objectives This study was conducted to detect and analyze the presence of plasmidmediated quinolone resistance (PMQR) determinants [qnr,aac-(6′)-Ib-cr and qepA] among clinical isolates of Citrobacter freundii strains isolated from patients in Anhui,China,and to understand the susceptibility of PMQR positive strains to commonly used antimicrobial agents.Methods During the year 2009,31 Citrobacter strains were collected from the First Affiliated Hospital of Anhui Medical University.Polymerase chain reaction (PCR) was used to detect PMQR genes.Amplicons were purified,sequenced and compared with data from the GenBank.Conjugation experiments were conducted to determine whether the qnr-carrying plasmids were self-transferable.The susceptibility of the positive isolates and transconjugants were tested by agar dilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines.The minimum inhibitory concentrations (MIC) of ciprofloxacin and levofloxacin were determined by E-test strips.Results Among the 31 Citrobacter strains,the qnr genes were detected in 8 isolates (25.8％),among which,6 carried qnrB.Aac-(6′)-Ib-cr and qepA were not identified in these isolates.The qnr genes were transferred from four clinical isolates to their transconjugants.Sequence analysis identified one novel qnrB variant (qnrB24).The resistant rate of qnr-positive clinical isolates to quinolone was 87.5 ％.Most of them were also resistant to various other antibiotics,including cefotaxime (75.0 ％),amikacin (7.5 ％),ceftazidime (62.5 ％),cefapime (37.5 ％),and gentamycin (87.5 ％).All qnr positive strains were susceptible to imipenem.MIC of all transconjugants showed reduced susceptibility to fluoroquinolones,with MIC increased by 10-23 folds.Conclusions Our study shows that qnr gene has occurred in Citrobacter freundii isolates from Anhui Province,China.QnrB is most prevalent in these isolates.Most qnr positive isolates are resistant to commonly used antimicrobial agents.
