本文選題：肺炎克雷伯菌　切入點(diǎn)：耐碳青霉烯類　出處：《中華醫(yī)院感染學(xué)雜志》2015年19期 　論文類型：期刊論文

【摘要】：目的了解耐碳青霉烯類肺炎克雷伯菌獲得性耐藥基因存在狀況及與常見可移動(dòng)遺傳元件的關(guān)系,探討其耐藥機(jī)制。方法收集2011年1月-2012年6月醫(yī)院住院患者分離到的20株耐碳青霉烯類肺炎克雷伯菌(菌種經(jīng)gyrA基因測(cè)序確認(rèn)),采用聚合酶鏈反應(yīng)法分析76種β-內(nèi)酰胺類、氨基糖苷類、喹諾酮類獲得性耐藥基因與可移動(dòng)遺傳元件標(biāo)記基因,并對(duì)檢測(cè)結(jié)果作指標(biāo)與樣本聚類分析。結(jié)果β-內(nèi)酰胺類與氨基糖苷類獲得性耐藥基因及可移動(dòng)遺傳元件遺傳標(biāo)記,每株均有陽(yáng)性發(fā)現(xiàn);20株菌共檢出2種β-內(nèi)酰胺類藥物獲得性耐藥基因、4種氨基糖苷類藥物獲得性耐藥基因、1種喹諾酮類藥物獲得性耐藥基因、5種可移動(dòng)遺傳元件遺傳標(biāo)記;陽(yáng)性基因可分為8種陽(yáng)性模式;指標(biāo)聚類分析提示,β-內(nèi)酰胺類藥物獲得性耐藥基因blaKPC、blaTEM與可移動(dòng)遺傳元件標(biāo)記intⅠ1、ISEcp1、ISKpn6高度連鎖,氨基糖苷類藥物獲得性耐藥基因rmtB與插入序列IS903也高度關(guān)聯(lián);樣本聚類分析提示,20株菌可分為A、B兩個(gè)簇群;A簇群又可分為A1和A2兩個(gè)亞簇群,A1亞簇群中的1~2、7~9號(hào)株、11~12號(hào)株3組分別為克隆傳播,B簇群也可分為B1和B2兩個(gè)亞簇群,B1與B2亞簇群分別為克隆傳播。結(jié)論該組菌株對(duì)β-內(nèi)酰胺類、氨基糖苷類藥物耐藥表型與基因型一致,指標(biāo)聚類分析提示獲得性耐藥相關(guān)基因和可移動(dòng)遺傳元件密切相關(guān),樣本聚類分析提示本組菌株存在多個(gè)克隆傳播。
[Abstract]:Objective to investigate the presence of acquired drug resistance genes of Klebsiella pneumoniae resistant to carbapenem and its relationship with common mobile genetic elements. Methods from January 2011 to June 2012, 20 strains of Klebsiella pneumoniae resistant to carbapenem (identified by gyrA gene sequencing) were collected and analyzed by polymerase chain reaction (PCR). Aminoglycosides, quinolones acquired resistance genes and transportable genetic element marker genes, Results the acquired drug resistance genes of 尾 -lactams and aminoglycosides and the genetic markers of mobile genetic elements were analyzed. Two 尾 -lactam acquired drug resistance genes, four aminoglycoside acquired resistance genes, one quinolone acquired resistance gene and five transportable genetic element genetic markers were found in 20 strains. The positive genes can be divided into 8 positive patterns, and the results of cluster analysis indicate that the 尾 -lactam acquired drug resistance gene blaKPC-blaTEM is highly linked to the mobile genetic element marker int 鈪，

本文編號(hào)：1643037