本文選題：肺炎克雷伯菌　切入點(diǎn)：耐碳青霉烯類(lèi)　出處：《中華醫(yī)院感染學(xué)雜志》2016年04期

【摘要】：目的了解耐碳青霉烯類(lèi)肺炎克雷伯菌(CRKP)對(duì)β-內(nèi)酰胺類(lèi)與氨基糖苷類(lèi)藥物的耐藥相關(guān)基因與可移動(dòng)遺傳元件存在狀況,以及獲得性耐藥相關(guān)基因與可移動(dòng)遺傳元件存在的相互關(guān)系。方法收集2014年1-12月住院患者標(biāo)本中分離到的20株CRKP,用gyrA測(cè)序后BLASTn比對(duì)確認(rèn)菌種,再采用聚合酶鏈反應(yīng)(PCR)法分析40種β-內(nèi)酰胺酶基因、6種氨基糖苷類(lèi)修飾酶、6種16SrRNA甲基化酶、12種可移動(dòng)遺傳元件遺傳標(biāo)記和blaKPC型與ISKpn6連鎖檢測(cè),并對(duì)檢測(cè)結(jié)果作指標(biāo)聚類(lèi)分析。結(jié)果 20株CRKP對(duì)9種β-內(nèi)酰胺類(lèi)與氨基糖苷類(lèi)均耐藥;獲得性耐藥相關(guān)基因與可移動(dòng)遺傳元件標(biāo)記每株均有陽(yáng)性發(fā)現(xiàn),共檢出4種β-內(nèi)酰胺酶基因(blaTEM、blaSHV、blaKPC、blaIMP),1種氨基糖苷類(lèi)修飾酶基因(aac(3)-Ⅱ)、1種16SrRNA甲基化酶基因(rmtB),8種可移動(dòng)遺傳元件遺傳標(biāo)記(traA、trbC、tnp513、IS26、IS903、ISEcp1、ISKpn6、intⅠ1);5株CRKP blaKPC-ISKpn6連鎖檢測(cè)為陽(yáng)性;指標(biāo)聚類(lèi)分析提示,β-內(nèi)酰胺酶基因blaIMP與tnp513強(qiáng)關(guān)聯(lián);β-內(nèi)酰胺酶基因blaKPC、blaSHV及16S rRNA甲基化酶基因rmtB與ISKpn6、ISEcp1、traA強(qiáng)關(guān)聯(lián);氨基糖苷類(lèi)修飾酶基因aac(3)-Ⅱ與IS26、IS903、intⅠ1、trbC強(qiáng)關(guān)聯(lián)。結(jié)論肺炎克雷伯菌耐藥表型與基因型結(jié)果相符,對(duì)β-內(nèi)酰胺類(lèi)與氨基糖苷類(lèi)藥物的耐藥與可移動(dòng)遺傳元件介導(dǎo)的blaTEM、blaSHV、blaKPC、blaIMP、aac(3)-Ⅱ、rmtB相關(guān)。
[Abstract]:Objective to investigate the presence of drug-resistant genes and removable genetic elements in 尾 -lactam and aminoglycoside drugs in Klebsiella carbapenem resistant Klebsiella pneumoniae (CRKP). Methods Twenty strains of CRKPs isolated from hospitalized patients from January to December 2014 were collected and identified by BLASTn comparison after gyrA sequencing. Polymerase chain reaction (PCR) was used to analyze 40 尾 -lactamases, 6 aminoglycoside modified enzymes, 6 16SrRNA methylases, 12 transportable genetic element genetic markers and blaKPC linkage to ISKpn6. Results 20 strains of CRKP were resistant to 9 kinds of 尾 -lactams and aminoglycosides, and acquired drug-resistance-related genes and mobile genetic element markers were positive for each strain, the results showed that 20 strains of CRKP were resistant to 9 kinds of 尾 -lactams and aminoglycosides. A total of 4 尾 -lactamases genes were identified. One aminoglycoside modified enzyme gene was identified as CRKP blaKPC-ISKpn6 linkage analysis of 8 transportable genetic element genetic markers, namely, TracbCnp513CnP513IS26IS903Ecp513IS903Ecp513IS26IS903 and CRKP blaKPC-ISKpn6 linkage analysis of 5 strains of CRKP mRNAs, and the results showed that the four 尾 -lactamases genes and 1 16SrRNA methylase gene were identified as CRKP linkage markers, and the results showed that the four 尾 -lactamases genes were identified to be positive for the detection of CRKP blaKPC-ISKpn6 linkage to 5 strains of CRKP gene, namely, tmtmttp513Cnp513tp513IS26IS903. Cluster analysis showed that 尾 -lactamase gene blaIMP was strongly associated with tnp513, and 尾 -lactamase gene blaKPC-blaSHV and 16s rRNA methylase gene rmtB were strongly associated with ISKpn6 ISEcp1a, while 尾 -lactamase gene blaIMP was strongly associated with tnp513, and 尾 -lactamase gene was strongly associated with ISKpn6 ISEcp1 gene and 16s rRNA methylase gene rmtB. The aminoglycoside modified enzyme gene aacan3t- 鈪，

本文編號(hào)：1666959