多药耐药肺炎克雷伯菌β-内酰胺酶基因及ompK36膜孔蛋白基因突变研究

β-lactamase gene and ompK36 membrane porin gene mutation in multidrug-resistant Klebsiella pneumoniae

目的了解多药耐药肺炎克雷伯菌（MDRKPN）所携带的β-内酰胺类药物耐药基因的状况。方法对20株MDRKPN进行了22种耐药基因的PCR法检测,包括A类β-内酰胺酶基因TEM、SHV、CTX-M-1群、CTX-M-2群、CTX-M-8群、CTX-M-9群、CTX-M-25群、PER、GES、VEB、CARB、LAP、KPC;B类β-内酰胺酶基因IMP、VIM、NDM;C类β-内酰胺酶基因LEN、OKP、DHA群;D类β-内酰胺酶基因OXA-10群、OXA-48群和膜孔蛋白基因ompK36。结果 20株MDRKPN检出4种β-内酰胺酶基因,分别为A类TEM、CTX-M-1、LAP和C类DHA,其ompK36膜孔蛋白基因检测出4株为基因缺失和16株为基因突变。结论 20株MDRKPN除1株外均检出1~3种β-内酰胺酶基因;ompK36膜孔蛋白基因检测结果显示,该蛋白均有缺陷;提示该组MDR-KPN耐β-内酰胺类药物为产β-内酰胺酶和ompK36膜孔蛋白缺陷的双重作用。

OBJECTIVE To understand the β-lactamase resistance genes in multi-drug resistant Klebsiella pneumoniae（MDR-KPN）.METHODS We detected 22 kinds of drug-resistance genes for 20 strains of MDR-KPN by PCR method,including the class A β-lactamase gene TEM,SHV,（CTX-M-1,2,8,9,25） groups,PER,GES,VEB,CARB,LAP,KPC;the class B β-lactamase gene IMP,VIM,NDM;the class C β-lactamase gene LEN,OKP,DHA group;the class D β-lactamase gene OXA-10 group,OXA-48 group and the membrane pore protein gene ompK36.RESULTS We found 4 kinds of β-lactamase genes in 20 strains of MDR-KPN,which included TEM,CTX-M-1,LAP and C class of DHA.There were 4 strains of gene-deletion and 16 strains gene-mutation in ompK36 membrane porin gene.CONCLUSIONS The strains of 20 MDR-KPN were detected 1-3 kinds of β-lactamase gene in addition to 1 strain.The test results of ompK36 membrane porin gene showed that the porin both had defects.It prompted that the resistant to β-lactamase of this group of MDR-KPN is for the producing of β-lactamase and ompK36 membrane protein defects in the dual role of holes.