多重耐药菌中质粒介导喹诺酮耐药基因的检测和分析

Detection and analysis on plasmid-mediated quinolone multi-drug resistant genes

目的分析广州医学院第一附属医院临床分离的60株多重耐药大肠埃希菌和肺炎克雷伯菌质粒介导的喹诺酮耐药基因存在状况。方法采用VITEK-2全自动细菌鉴定仪检测大肠埃希菌和肺炎克雷伯菌对抗生素的药物敏感性，选择多重耐药的大肠埃希菌和肺炎克雷伯菌作为研究对象，用多重PCR法进行质粒介导的喹诺酮耐药基因的检测和分析。结果检测出耐药基因qnrA型2株，qnrB型耐药基因15株，aac（6’）-Ib基因9株，其中aac（6’）-Ib—cr型耐药基因5株。其中有1株肺炎克雷伯菌检测到同时含有qnrA和aac（6’）-Ib—cr基因；还有3株肺炎克雷伯菌检测到同时含有qnrB和aac（6’）-Ib—cr基因。未检测到qnrC、qnrD、qnrS、qepA型的耐药基因。结论临床分离的多重耐药大肠埃希菌和肺炎克雷伯菌含有多种质粒介导的喹诺酮耐药基因，应引起临床的重视。

Objective To analyze the presence of plasmid-mediated quinolone resistant genes 60 strains of multi-drug resistant Escherichia coli and Klebsiella pneumoniae isolated from the First Affiliated Hospital of Guangzhou Medical College. Methods Using VITEK-2 automatic identification system, antibiotic susceptibility of E.coli and K. pneumnniae were tested. Muhi-drug resistant E. coil and K. pneumoniae were selected for research. The presence of plasmid-mediated quinolone resistant genes were detected by multiplex PCR. Results qnrA genes were detected in 2 strains, qnrB were detected in 15 strains and aac （6＇） - Ib gene were detected in 9 strains, with aac （6＇）-Ib -cr in 5 strains. One strain of K. pneumoniae carried both qnrA and aac （6＇）-Ib-cr genes and 3 strains of K. pneumoniae carried both qnrB and aac （6＇）-Ib-cr genes, qnrC,qnrD, qnrS, qepA genes were not detected. Conclusion Clinical isolates of multi-drug resistant E. coli and K. pneumoniae carried multiple plasmid mediated quinolone resistant genes, which should be drew more attention in clinic.