摘要
目的 对我院1株美罗培南耐药(纸片扩散法)的肺炎克雷伯菌进行基因型分析.方法 采用k-b法和微量肉汤稀释法进行耐药表型检测,应用改良hodge试验和edta协同试验检测金属酶.pcr法检测包括碳青每烯酶在内的多种β-内酰胺酶基因、Ⅰ类整合酶、Ⅰ类整合子,并进行测序分析.结果 多重耐药肺炎克雷伯菌除对氨曲南、庆大霉素、妥布霉索、阿米卡星、环丙沙星和左氧氟沙星敏感外,对碳青霉烯类、头孢菌素类、头孢西丁、氨苄西林和复方磺胺甲恶唑均耐药.pcr检测显示该菌株携带imp型金属β-内酰胺酶基因,dna测序分析显示扩增出的基因属于imp-1型,Ⅰ类整合酶、Ⅰ类整合子检测阳性.结论 首次在国内分离到产imp-1型金属β-内酰胺酶的肺炎克雷伯菌,该酶是引起肺炎克雷伯菌耐碳青霉烯类抗生素的主要原因,并且与Ⅰ类整合子有关.
abstract：
objective to study the genes of a carbapenem-resistant klebsiella pneumoniae strain isolated from a patient. methods the antibiotic sensitivity test of a multidrug-resistant klebsiella pneumoniae strain was done according to k-b and mic method. metallo-β-lactamase was detected by modified hodge test and edta-disk synergy test. both nine genes encoding β-lactamases, including blakpc, blaimp , blavim , blasme , blactx-m , blashv, bladha , blaact, class Ⅰ integrase and class Ⅰ integron were detected by pcr. positive products were sequenced. results the klebsiella pneumoniae was resistant to carbapenems, cephalosporins, cefoxitin, ampicillin and trimethoprim/sulfamethoxazole. only susceptible to aztreonam, gentamicin, tobramycin, amikacin, ciprofloxacin and levofloxacin. the blaimp-1 and class Ⅰ integron were positive. the blaimp gene was identified by pcr and dna sequencing confirmed that the gene belong to imp-1 type metallo-β-lactamase gene. the strain also carried class Ⅰ integron and imp-1 was located in class Ⅰ integron 5'. conclusions it is the first de
Objective To study the genes of a carbapenem-resistant Klebsiella pneumoniae strain isolated from a patient. Methods The antibiotic sensitivity test of a multidrug-resistant Klebsiella pneumoniae strain was done according to K-B and MIC method. Metallo-β-lactamase was detected by Modified Hodge Test and EDTA-disk synergy test. Both nine genes encoding β-lactamases, including blaKPC, blaIMP , blaVIM , blaSME , blaCTX-M , blaSHV, blaDHA , blaACT, Class Ⅰ integrase and Class Ⅰ integron were detected by PCR. Positive products were sequenced. Results The Klebsiella pneumoniae was resistant to carbapenems, cephalosporins, cefoxitin, ampicillin and trimethoprim/sulfamethoxazole. Only susceptible to aztreonam, gentamicin, tobramycin, amikacin, ciprofloxacin and levofloxacin. The blaIMP-1 and Class Ⅰ integron were positive. The blaIMP gene was identified by PCR and DNA sequencing confirmed that the gene belong to IMP-1 type Metallo-β-lactamase gene. The strain also carried Class Ⅰ integron and IMP-1 was located in Class Ⅰ integron 5'. Conclusions It is the first detection of IMP-1 Metallo-β-lactamase in Klebsiella pneumoniae. The production of IMP-1 carbapenemase is the main mechanism of carbapenem-resistant in Klebsiella pneumoniae, and multidrug resistance is related to ClassⅠ integron.
出处
《中华临床感染病杂志》
CAS
2011年第3期-,共5页
Chinese Journal of Clinical Infectious Diseases
