泛耐药产酸克雷伯菌的耐药基因研究

Investigation to the drug resistance genes for one strain of Klebsiella oxytoca with pan-resisatnce

目的了解1株对临床常用18种抗菌药物(包括亚胺培南、美洛培南)均耐药的产酸克雷伯菌(Klebsiella oxytoca,Kox)所携带的耐药基因状况。方法对该株Kox菌进行了9类耐药基因的PCR法检测,包括β-内酰胺酶基因blaTEM,blaSHV,blaLEN,blaOKP,blaCTX-M-1、2、9群,blaOXA-1、2、10群,blaCARB,blaPER,blaVEB,blaGES,金属β-内酰胺酶基因blaIMP、blaVIM、blaKPC,AmpC酶基因blaDHA、blaACT/MIR、blaCMY/MOX、bla CMY/LAT,氨基糖苷修饰酶基因aac(3)-Ⅰ、aac(3)-Ⅱ、aac(6’)-Ⅰb、aac(6’)-Ⅱ、ant(2")-Ⅰ、ant(3")-Ⅰ,喹诺酮类耐药基因qnrA,TMP耐药基因dfrA1、dfrA17,消毒剂磺胺耐药基因qacE△1-sul1,整合子遗传标记基因intⅠ1、intⅠ2、intⅠ3,转座子遗传标记基因tnpA、merA,共计36种。结果本株Kox菌共检出9种耐药基因,分别为β内酰胺酶基因blaTEM,blaSHV,金属β-内酰胺酶基因blaKPC-2,氨基糖苷修饰酶基因aac(3)-Ⅱ,ant(3")-Ⅰ,喹诺酮类耐药基因qnrA,TMP耐药基因dfrA17,消毒剂磺胺耐药基因qacE△1-sul1,整合子遗传标记基因intⅠ1。结论在本株泛耐药Kox菌中发现了少见的blaKPC-2金属β-内酰胺酶基因,本菌对18种抗菌药物的耐药可能与其同时携带有多种耐药基因有关,临床应对此类菌株引起重视。

Objective To investigate the drug resistance genes from a Klebsiella oxytoca(Kox)isolate demonstrating resistance to 18 kinds of antibacterials including imipenem and meropenem.Methods 36 kinds of drug resistance genes of the strain of Klebsiella oxytoca were detected by PCR method which included:beta-lactamases genes,blaTEM,blaSHV,blaLEN,blaOKP,blaCTX-M-1、2、9 groups,blaOXA-1、2、10 groups,CARB,PER,VEB,GES;the genes of metallo-beta-lactamases genes,IMP、VIM、KPC;AmpC genes,DHA、ACT、MOX、LAT;The aminoglycosides resistant genes,aac(3)-Ⅰ、 aac(3)-Ⅱ、aac(6’)-Ⅰb、 aac(6’)-Ⅱ、 ant(2")-Ⅰ、 ant(3")-Ⅰ;The quinolones resistant gene qnrA;the TMP resistant genes,dfrA1、dfrA17;the disinfectant-sulfasulfonamide resistant,qacE1-sul1;the integron genes,intⅠ-1、intⅠ-2、 intⅠ-3;the transposon genes,tnpA、merA.Results We found 9 kinds of drug resistance genes in this Klebsiella oxytoca.They were beta-lactamases genes,blaTEM,blaSHV;metallo-beta-lactamases,genes KPC-2;The aminoglycosides resistant genes,aac(3)-Ⅱ、 ant(3")-Ⅰ;The quinolones resistant gene qnrA;the TMP resistant genes dfrA17;the disinfectant-sulfasulfonamide resistant gene qacE1-sul1 and the integron genes intⅠ-1.Conclusion We discovered multiple drug resistant genes(some in the chromosome,some plasid-mediated)in this isolate.We also found the infrequent plasid-mediated drug resistant gene KPC-2,It may be concerned with the pen-resistant and the multiple drug resistant genes in this Kox,and,we should take us highly notice to this ioslate in clinic.