肺炎克雷伯菌整合子分布与耐药性关系
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摘要
目的通过调查Ⅰ、Ⅱ、Ⅲ类整合子在临床分离产ESBL与非产ESBL肺炎克雷伯菌中的分布情况,分析其与细菌耐药性关系。方法收集并保存临床送检标本分离出的产ESBLs肺炎克雷伯菌30株,非产ESBLs肺炎克雷伯菌50株;采用BD phoenix100全自动细菌鉴定仪进行鉴定及药敏试验;整合子及可变区测定采用聚合酶链式反应(PCR)扩增和琼脂糖凝胶电泳,并对可变区阳性菌株进行测序分析。结果 80株肺炎克雷伯菌中检测出整合子Ⅰ阳性菌株共30株;其中,在产ESBL菌株中检出率为73.3%(22/30);非产ESBL肺炎克雷伯菌中检出率为16%(8/50);未检出Ⅱ类及Ⅲ类整合子。有8株成功扩增出可变区,检出dfrA1,dfrA12,dfrA17,dfrA25,AaadA1,aadA2,aadA5,orfC,orfF,cmlA1共10种耐药基因盒,与耐药表型有一定的相关性。结论 I类整合子在ESBL和非产ESBL的肺炎克雷伯菌中的分布存在明显差异,显示其与细菌耐药性关系密切,应予以足够重视。
Objective To investigate the distribution of I,II,III integrons in ESBL-producing and non-ESBL-producing Klebsiella pneumonia(KP),exploring the relationship between the drug resistance characteristics and the integrons in our hospital.Methods 30 strains of KP producing ESBLs and 50 strains of non-ESBLs KP were isolated and preserved from clinical specimens.The BD phoenix100 automatic bacteria identification instrument was used for identification and drug susceptibility testing;integrons and variable regions were detected using Polymerase Chain Reaction(PCR)and agarose gel electrophoresis,and variable region were sequenced to clarify the context of gene cassette.Results 30 strains of classs 1 integron-positive strains were detected in 80 strains of KP;among them,the detection rate of that in ESBL-producing strains was 73.3%(22/30);which in non-ESBL-producing strains was 16%(8/50);and no classⅡandⅢintegrons was detected.The variable regions were successfully amplified in 8 strains for classs I integronpositive and 10 drug-resistant gene boxes including dfrA1,dfrA12,dfrA17,dfrA25,AaadA1,aadA2,aadA5,orfC,orfF and cmlA1 were found.There's some correlation between the gene cassette carried by ingegron with the resistance phenotype.Conclusion The distribution of class I integrons in ESBL and non-ESBL-producing KP is significant.The difference showed that it is closely related to the resistance,which should be paid enough attention.
Objective To investigate the distribution of I,II,III integrons in ESBL-producing and non-ESBL-producing Klebsiella pneumonia(KP),exploring the relationship between the drug resistance characteristics and the integrons in our hospital.Methods 30 strains of KP producing ESBLs and 50 strains of non-ESBLs KP were isolated and preserved from clinical specimens.The BD phoenix100 automatic bacteria identification instrument was used for identification and drug susceptibility testing;integrons and variable regions were detected using Polymerase Chain Reaction(PCR)and agarose gel electrophoresis,and variable region were sequenced to clarify the context of gene cassette.Results 30 strains of classs 1 integron-positive strains were detected in 80 strains of KP;among them,the detection rate of that in ESBL-producing strains was 73.3%(22/30);which in non-ESBL-producing strains was 16%(8/50);and no classⅡandⅢintegrons was detected.The variable regions were successfully amplified in 8 strains for classs I integronpositive and 10 drug-resistant gene boxes including dfrA1,dfrA12,dfrA17,dfrA25,AaadA1,aadA2,aadA5,orfC,orfF and cmlA1 were found.There's some correlation between the gene cassette carried by ingegron with the resistance phenotype.Conclusion The distribution of class I integrons in ESBL and non-ESBL-producing KP is significant.The difference showed that it is closely related to the resistance,which should be paid enough attention.
引文
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[10]秦声远,陈风.产ESBL肺炎克雷伯菌的β-内酰胺类与氨基糖苷类和磺胺类耐药元件分析[J].中华医院感染杂志,2017,27(21)4815.
[11]茅孝莹,许小敏,陈琳,等.大肠埃希菌临床连续分离株常见耐药元件检测与分析[J].中华医院感染学杂志,2017,27(21):4801.
[2]邹红波.肺炎克雷伯杆菌产超广谱β-内酰胺酶情况及耐药性探究[J].临床医药文献杂志,2017,4(70):13668.
[3]蔡应木,陈淑贞,郑宇琼,等.产ESBLs肺炎克雷伯菌Ⅰ类整合子基因盒的研究[J].中国微生态学杂志,2009,21(2):169.
[4]黄娟,王欣,吴志毅,等.多重耐药铜绿假单胞菌Ⅰ类整合子-基因盒的检测与分析[J].微生物学免疫学进展,2017,45(5):21.
[5]Elisabete Machado,Rafael Canton,Fernando Baquero,et al.Integron Content of Extended-Spectrum-β-Lactamase-Producing Escherichia coli Strains over 12Years in a Single Hospital in Madrid,Spain[J].American Society for Microbiology,2005,49(5):1823.
[6]朱丽芳.肺炎克雷伯菌463株的临床分布和药敏分析[J].现代医药卫生,2017,33(15):2404.
[7]林琳,刘佳坤,王晶.ICU产ESBLs肺炎克雷伯杆菌与整合子相关性研究[J].医学与哲学,2016,37(541):74.
[8]李亚军,陈代杰,李继安.肺炎克雷伯菌中整合子的研究进展[J].中国抗生素杂志,2013,38(10):721.
[9]欧阳润泽,贺艳艳,徐海.细菌整合子中整合酶基因调控的研究进展[J].微生物学报,2015,55(10):1231.
[10]秦声远,陈风.产ESBL肺炎克雷伯菌的β-内酰胺类与氨基糖苷类和磺胺类耐药元件分析[J].中华医院感染杂志,2017,27(21)4815.
[11]茅孝莹,许小敏,陈琳,等.大肠埃希菌临床连续分离株常见耐药元件检测与分析[J].中华医院感染学杂志,2017,27(21):4801.