摘要
目的研究20株耐碳青霉烯类与喹诺酮类肺炎克雷伯菌的耐药机制。方法 20株肺炎克雷伯菌分离自2012年1-6月医院住院患者的痰液样本,采用改良的Hodge试验检测碳青霉烯酶活性,再用PCR法检测A^D类40种β-内酰胺酶基因和喹诺酮类耐药基因。结果 20株肺炎克雷伯菌经改良的Hodge试验检测均有碳青霉烯酶活性,均检出TEM-1和KPC-2型β-内酰胺酶基因,出现gyrA基因第83位密码子TCC→ATC突变(氨基酸序列S→I),第87位密码子GAC→GGC突变(氨基酸序列D→G)。结论肺炎克雷伯菌携带KPC-2型β-内酰胺酶基因和存在gyrA基因QRDR区突变,其是碳青霉烯类与喹诺酮类药物的耐药机制,肺炎克雷伯菌药敏表型与耐药基因型相同疑似医院感染。
OBJECTIVE To investigate the resistant mechanism of 20 strains of carbapenem-and quinolone-resistant Klebsiella pneumoniae.METHODS Totally 20 strains of K.pneumoniae were isolated from sputum specimens from inpatients in a third-grade hospital from Jan.to Jun.2012.The modified Hodge test was performed to detect activities of carbapenemase,then 40 kinds of class A-D beta-lactamase genes and quinolone-resistant genes were analyzed by PCR.RESULTS The modified Hodge test showed all 20 strains had carbapenemase activities,TEM-1and KPC-2were all positive,and TCC→ATC mutation emerged in 83 rd codon of gyrA（amino acid sequence S→I）,and GAC→GGC mutation emerged in 87 th codon of gyrA（amino acid sequence D→G）.CONCLUSION Carrying KPC-2and mutations of QRDR in gyrA was the resistant mechanism of carbapenem-and quinoloneresistant K.pneumoniae,and the coincidence of phenotypes and genotypes suggested that hospital infection existed.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第19期4687-4689,共3页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技计划基金资助项目(2013KYA220)
浙江省金华市科技重点基金资助项目(2012-3-022)
