氨基糖苷类修饰酶基因在我院分离产超广谱β内酰胺酶肺炎克雷伯菌中的表达

Expressions of aminoglycoside modifying enzymes genes in extended-spectrum β-lactamase-producing Klebsiella pneumoniae isolates

目的 调查氨基糖苷类修饰酶（AMEs）基因在泰安中心医院院内分离的产超广谱β内酰胺酶（ESBL）肺炎克雷伯菌中的表达情况,为合理使用抗菌药物提供依据.方法 采用多聚酶链反应（PCR）方法,检测aac（3）-Ⅰ、aac（3）-Ⅱ、aac（3）-Ⅲ、aac（3）-Ⅳ、aac（6＇）-Ⅰ、ac（6＇）-Ⅱ、aph（3＇）-Ⅵ、ant（3＂）-Ⅰ和ant（2＂）-Ⅰ等9种AMEs,在42株院内分离的产ESBL肺炎克雷伯菌中的表达情况.结果 42株产ESBL肺炎克雷伯菌中,36株（85.7%）携带aac（3）-Ⅱ基因,25株（59.5%）携带ant（3＂）-Ⅰ基因,9株（21.4%）携带aac（6＇）-Ⅰ基因,4株（9.5%）携带aph（3＇）-Ⅵ基因,3株（7.1%）携带aac（3）-Ⅰ基因,AMEs携带率为90.5%（38/42）.结论 我院院内分离的产ESBL肺炎克雷伯菌的AMEs基因携带率很高,其对氨基糖苷类药物耐药可能与AMEs有关.

Objective To investigate the expressions of aminoglycoside modifying enzymes （AMEs）genes of extended-spectrum β-lactamase-producing Klebsiella pneumoniae （ESBL-KP） isolates in our hospital, with an attempt to provide evidence for rational clinical antibiotics use. Mothods A total of 42 strains of ESBL-KP were isolated from January 2007 to January 2008 in our hospital The expressions of 9 AMEs including aac （3）-Ⅰ , aac （3）-Ⅱ , aac （3）-l, aac （3）-Ⅳ, aac （6＇）- Ⅰ , aac （6＇）-Ⅰ, apb （3＇）-Ⅵ, ant （3＂）-Ⅰ, and ant （2＂） -Ⅰ were identified by polymerase chain reaction. Results The positive rates of aac （3） - Ⅱ, ant （3＂） - Ⅰ ,aac （6＇） - Ⅰ , apb （3＇） -Ⅵ, and aac （3） - Ⅰ were 85. 7%, 59. 5%, 21.4% , 9. 5%, and 7. 1% , respectively. All the other genotypes were negative. The positive rate of AMEs reached 90. 5% （38 of 42）. Conclusions The expression rates of AMEs genes are high among ESBL-KP isolates in our hospital. The aminoglycoside resistance may be relevant with AMEs.