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
2014年
2期
150-156
,共7页
李莺%丁云芳%吴水燕%陶云珍%项龙%柏振江%陈红梅
李鶯%丁雲芳%吳水燕%陶雲珍%項龍%柏振江%陳紅梅
리앵%정운방%오수연%도운진%항룡%백진강%진홍매
克雷伯菌,肺炎%抗药性,多药%支气管肺泡灌洗液%耐药元件
剋雷伯菌,肺炎%抗藥性,多藥%支氣管肺泡灌洗液%耐藥元件
극뢰백균,폐염%항약성,다약%지기관폐포관세액%내약원건
Klebsiella pneumoniae%Drug resistance,multiple%Bronchoalveolar lavage fluid%Resistance element
目的 分析1株多重耐药肺炎克雷伯菌耐药基因的存在状况及耐药机制.方法 采用聚合酶链反应(PCR)及序列分析的方法对2012年2月分离白苏州大学附属儿童医院儿科重症监护病房患儿支气管肺泡灌洗液中的1株多重耐药肺炎克雷伯菌进行β-内酰胺酶类、氨基糖苷类、喹诺酮类获得性耐药相关基因、膜孔蛋白基因ompK35、ompK36及PBP2编码基因检测.结果 该株多重耐药肺炎克雷伯菌耐β-内酰胺类药物获得性耐药基因检出 TEM-1和SHV-1;氨基糖苷类药物获得性耐药基因检出 aac(6′)-I b,无16S rRNA甲基化酶基因检出;膜孔蛋白编码基因ompK35和ompK36均呈阴性;碳青霉烯类药物作用靶位PBP2编码基因测序与敏感株相比仅有9个同义突变,但氨基酸序列不变.与敏感株相比,该菌株无氟喹诺酮耐药决定区(QRDR)突变.结论 该株多重耐药肺炎克雷伯菌耐β-内酰胺类、氨基糖苷类及碳青霉烯类药物与细菌产2种β-内酰胺类获得性耐药基因、1种氨基糖苷类获得性耐药基因、膜孔蛋白基因缺陷和PBP2基因同义突变相关.
目的 分析1株多重耐藥肺炎剋雷伯菌耐藥基因的存在狀況及耐藥機製.方法 採用聚閤酶鏈反應(PCR)及序列分析的方法對2012年2月分離白囌州大學附屬兒童醫院兒科重癥鑑護病房患兒支氣管肺泡灌洗液中的1株多重耐藥肺炎剋雷伯菌進行β-內酰胺酶類、氨基糖苷類、喹諾酮類穫得性耐藥相關基因、膜孔蛋白基因ompK35、ompK36及PBP2編碼基因檢測.結果 該株多重耐藥肺炎剋雷伯菌耐β-內酰胺類藥物穫得性耐藥基因檢齣 TEM-1和SHV-1;氨基糖苷類藥物穫得性耐藥基因檢齣 aac(6′)-I b,無16S rRNA甲基化酶基因檢齣;膜孔蛋白編碼基因ompK35和ompK36均呈陰性;碳青黴烯類藥物作用靶位PBP2編碼基因測序與敏感株相比僅有9箇同義突變,但氨基痠序列不變.與敏感株相比,該菌株無氟喹諾酮耐藥決定區(QRDR)突變.結論 該株多重耐藥肺炎剋雷伯菌耐β-內酰胺類、氨基糖苷類及碳青黴烯類藥物與細菌產2種β-內酰胺類穫得性耐藥基因、1種氨基糖苷類穫得性耐藥基因、膜孔蛋白基因缺陷和PBP2基因同義突變相關.
목적 분석1주다중내약폐염극뢰백균내약기인적존재상황급내약궤제.방법 채용취합매련반응(PCR)급서렬분석적방법대2012년2월분리백소주대학부속인동의원인과중증감호병방환인지기관폐포관세액중적1주다중내약폐염극뢰백균진행β-내선알매류、안기당감류、규낙동류획득성내약상관기인、막공단백기인ompK35、ompK36급PBP2편마기인검측.결과 해주다중내약폐염극뢰백균내β-내선알류약물획득성내약기인검출 TEM-1화SHV-1;안기당감류약물획득성내약기인검출 aac(6′)-I b,무16S rRNA갑기화매기인검출;막공단백편마기인ompK35화ompK36균정음성;탄청매희류약물작용파위PBP2편마기인측서여민감주상비부유9개동의돌변,단안기산서렬불변.여민감주상비,해균주무불규낙동내약결정구(QRDR)돌변.결론 해주다중내약폐염극뢰백균내β-내선알류、안기당감류급탄청매희류약물여세균산2충β-내선알류획득성내약기인、1충안기당감류획득성내약기인、막공단백기인결함화PBP2기인동의돌변상관.
Objective To analyze the resistance genes in a muhidrug resistant Klebsiella pneumoniae (MDRKP) strain.Methods A MDRKP strain was isolated from bronchoalveolar lavage fluid in Pediatric Intensive Care Unit of Children's Hospital Affiliated to Soochow University in February 2012.Acquired resistance genes to beta-lactams,aminoglycosides,quinolones,ompK35 and ompK36 gene for outer membrane porin protein,and carbapenems targeting PBP2 gene were analyzed by PCR and verified by DNA sequencing.Results Acquired resistance genes TEM-1,SHV-1 to beta-lactam antimicrobial agents and aac(6′)-I b to aminoglycoside antimicrobial agents were positive in the strain of MDRKP.While 16S rRNA methylase,ompK35 and ompK36 genes for outer membrane porin protein were negative.Compared with susceptible strains,there were 9 synonymous mutations in PBP2 gene sequence of this MDRKP strain,but the amino acid sequences were the same.No mutation in quinolone resistance determining region (QRDR) was observed.Conclusion The multidrug resistance of the isolated Klebsiella pneumoniae strain may be related to 2 kinds of beta-lactam acquired resistance genes,1 kind of aminoglycoside acquired resistance gene,ompK35 and ompK36 genes defects and synonymous mutation in PBP2 gene.
