【摘要】 目的明确广州地区引起医院感染的肺炎克雷伯菌耐药性及氨基糖苷类修饰酶、β内酰胺酶基因存在状况。方法采用MicroScan微生物鉴定系统NC21试验板微量肉汤法,测定20株医院感染分离的肺炎克雷伯菌对20种抗菌药物的敏感性,采用聚合酶链反应技术分析9种氨基糖苷类修饰酶基因和2种β内酰胺酶基因。结果该20株菌呈现多重耐药,除对亚胺培南敏感率高达95%外,对氨基糖苷类抗菌药物的耐药率在75.0%～90.0%之间,其他药物耐药率为55%～100%;18株(90.0%)检出氨基糖苷类修饰酶基因,ant(3″)Ⅰ、aac(6′)Ⅰ、aac(3)Ⅱ、aac(3)Ⅰ、aac(6′)Ⅱ和aph(3′)Ⅵ基因阳性率分别为80.0%、70.0%、65.0%、35.0%、25.0%和5.0%,aac(3)Ⅲ、aac(3)Ⅳ和ant(2″)Ⅰ基因均阴性;20株菌均检出β内酰胺酶编码基因,其中TEM基因阳性率85.0%,DHA基因阳性率80.0%。结论广州地区临床分离的肺炎克雷伯菌多重耐药严重,氨基糖苷类修饰酶基因和β内酰胺酶编码基因携带率很高,存在DHA型质粒AmpC酶基因。更多还原

【Abstract】 OBJECTIVE To investigate the antimicrobial resistance and genotyping of aminoglycoside-modifying enzymes (AMEs) and β-lactamases (BLs) in Klebsiella pneumoniae (KPN) isolated from hospital-acquired infection in Guangzhou. METHODS The sensibility of KPN was identified to 20 antibiotics, and the minimum inhibitory concentrations (MIC) were determined by Neg Combo Panel Type 21 (Dade MicroScan). Two BLs genotypes and nine AMEs genotypes in 20 strains of KPN were verified by polymerase chain reaction (PCR) and DNA sequencing technique. RESULTS The 20 strains of KPN were multi-resistant.They only showed high susceptibility to imipenem with 95% susceptible rate, but resistant to aminoglycosides (resistance rates were 75.0-90.0%) and other antibiotics (resistance rates were 55.0-100%). Eighteen strains(90.0%) could be found one or more types of AMEs gene. The rates of ant (3″)-Ⅰ, aac(6′)-Ⅰ, aac(3)-Ⅱ, aac(3)-Ⅰ, aac(6′)-Ⅱ, aph(3′)-Ⅵ, aac(3)-Ⅲ, aac(3)-Ⅳand ant(2″)-Ⅰgenes were 80.0%, 70.0%, 65.0%, 35.0%, 25.0%, 5.0%, 0, 0 and 0, respectively. Twenty strains all could be found BLs gene, including blaTEM (85.0%) and blaDHA (80.0%). CONCLUSIONS The study showed that K. pneumoniae strains were serious multi-drug resistant and with higher BLs and AMEs gene expression in Guangzhou, and the strains carrying DHA gene could be found generally.更多还原