产ESBLs肺炎克雷伯菌的耐药基因谱及遗传学特征

Resistance gene spectrum and genetics characteristics of klebsiella pneumoniae producting ESBLs

目的:了解产ESBLs肺炎克雷伯菌的耐药基因谱及其遗传学特征。方法:对35株产ESBLs肺炎克雷伯菌,采用聚合酶链反应(PCR)检测aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅱ,ant(3″)-Ⅰ,ant(2″)-Ⅰ,aac(6′)-Ⅰ,aac(6′)-Ⅰb等7种氨基糖苷类修饰酶基因,TEM,SHV,LEN,OKP,CTXM-1,CTXM-2,CTXM-9,GES,PER,VEB,OXA-10,OXA-1,OXA-2,DHA,ACT-1等15种β-内酰胺酶基因,intI1,intI2,intI3等3种整合子基因,tnpA(TnA转座子标记),merA(Tn21/Tn501转座子标记),qacEΔ1-sul1消毒剂耐药基因,qnr喹诺酮类耐药基因,共检测29种耐药基因并对部分产物进行测序。结果:35株肺炎克雷伯菌中检出β-内酰胺酶基因22株,阳性率62.9%。整合子基因阳性22株,阳性率62.9%。氨基糖苷类修饰酶基因阳性26株,阳性率74.3%。tnpA全部阴性。merA阳性2株,阳性率5.7%。qacEΔ1-sul1阳性13株,阳性率37.1%。qnr全部阴性。在测序中发现一种新的基因型,并以aac(6′)-Ⅰb-Suzhou型命名,登录于美国NCBI(登录号:EF375621)。结论:产ESBLs肺炎克雷伯菌的耐药基因及耐消毒剂基因的携带率非常高,耐药基因谱及其遗传学特征非常复杂。

Objective： To understand the resistance gene spectrum and genetics characteristics of Kleb- sieUa pneumoniae（ Kpn ） producting ESBLs. Methods ： The genes including aac （ 3 ） - I, aac （ 3 ”） - 11, aac （ 6＇ ）- II, ant （ 3”）- I, ant （ 2”）- I, aac （ 6＇ ）- I, aac （6＇）- I b, TEM, SHV, LEN, OKP, CTX-M-1, CTX-M- 2, CTX-M-9, GES, PER, VEB, OXA-10, OXA-1, OXA-2, DHA, ACT-I, intI1, intI2, intI3, tnpA, merA, qnr,qacEAl-sull were analyzed by PCR. And Some products were sequenced. Results： β-1actamase gene was found in 62.9% ,AMEs gene was found in 74.3% ,tnpA was all negative,Integron gene was found in 62.9% ,merA was found in 5.7% ,qnr was all negative,qacEAl-sull was found in 37.1% in 35 Kpn. We found a new genotype and named as aac（6＇）-I b-Suzhou,which we have registrated in NCBI（Login： EF375621 ）. Conclusion： The carrying rates of resistance gene and disinfectant-resistant gene were very high, resistance gene spectrum and genetics characteristics of Kpn producting ESBLs were very complex.