摘要
目的了解临床分离的54株肺炎克雷伯菌对氨基糖苷类抗生素的耐药谱,分析氨基糖苷乙酰转移酶基因的分布规律及其与氨基糖苷类抗生素耐药的相关性,为临床抗感染治疗提供依据。方法采用MIC法测定临床分离的54株肺炎克雷伯菌对7种氨基糖苷类抗生素的耐药谱,应用Whonet5.4软件统计耐药率,通过聚合酶链反应进行氨基糖苷乙酰转移酶基因研究。结果 54株肺炎克雷伯菌对阿米卡星、庆大霉素、妥布霉素、卡那霉素、链霉素、大观霉素和奈替米星的耐药率分别为14.8%、77.8%、59.3%、68.5%、66.7%、61.1%、22.2%;测试菌株中存在aac(3)-Ⅱ、aac(6′)-Ⅰ、aac(3)-Ⅳ、aac(3)-Ⅰ4种耐药基因,aac(3)-Ⅱ和aac(6′)-Ⅰ是主要的产酶基因,检出率分别为78.5%和65.0%。结论产生氨基糖苷类钝化酶是临床分离的肺炎克雷伯菌对氨基糖苷类抗生素主要的耐药机制,临床分离菌的耐药表型和钝化酶基因关系较为复杂,可能与耐药菌中存在多钟耐药基因有关,临床实验室应加强检测,指导临床合理使用抗菌药物。
Objective To understand antibiotic resistance profile for AGs in 54 strains of Klebsiella pneumoniae,and investigate the aminoglycoside resistance profiles and the situation of aminoglycoside acetyltransferases gene of clinical Klebsiella pneumoniae strains.Methods Micro-broth dilution method was used to identify MIC of 7 aminoglycosides for 54 Klebsiella pneumoniae and their aac gene patterns were confirmed by PCR,statistical resistance was gained by software Whonet5.4.Results The antibiotic resistance profiles were related with aac gene patterns.The four aac genes were identified,aac（3）-Ⅱ、aac（6′）-Ⅰ、aac（3）-Ⅳ、aac（3）-Ⅰ,the frequence of aac（3）-Ⅱ and aac（6′）-Ⅰ was 78.5% and 65.0% from these Klebsiella pneumoniae strains.Conclusion Aminoglycoside acetyltransferases gene is the major factor which confers aminoglycoside resistance on Klebsiella pneumoniae.Bacteria antibiotic resistance profiles are more intricacy compared with aac gene patterns.We should strengthen detection,guide clinical rational use of antimicrobial agents.
出处
《检验医学与临床》
CAS
2011年第11期1315-1317,共3页
Laboratory Medicine and Clinic
关键词
肺炎克雷伯菌
氨基糖苷类抗生素
aac基因
Klebsiella pneumoniae
aminoglycoside antibiotic
aminoglycoside acetyltransferases gene
