【摘要】：目的了解產(chǎn)AmpC酶肺炎克雷伯菌對(duì)氨基糖苷類耐藥基因、AmpC型β-內(nèi)酰胺酶基因,整合子遺傳標(biāo)記的存在狀況以及菌株的親緣關(guān)系。方法收集醫(yī)院住院患者痰液標(biāo)本中分離的肺炎克雷伯菌20株,頭孢西丁三維試驗(yàn)均為陽(yáng)性,采用聚合酶鏈反應(yīng)(PCR)法分析7種氨基糖苷類修飾酶、6種16SrRNA甲基化酶、6種AmpC型β-內(nèi)酰胺酶基因和3種整合子遺傳標(biāo)記,并對(duì)檢測(cè)結(jié)果作樣本聚類分析。結(jié)果 20株產(chǎn)AmpC酶肺炎克雷伯菌均檢出氨基糖苷類耐藥基因和blaDHA、intⅠ1基因,氨基糖苷類修飾酶基因檢出aac(3)-Ⅱ18株、aac(6')-Ⅰb 10株、ant(3″)-Ⅰ5株,檢出陽(yáng)性率分別為90.0%、50.0%、25.0%,16SrRNA甲基化酶檢出rmtB2株,檢出陽(yáng)性率為85.0%;樣本聚類分析提示,該組菌可分為兩個(gè)簇群,A簇群中又可分為A1、A2兩個(gè)亞簇群,A1亞簇群中可分為A1.1(1、5、7、8、10、12、16、20號(hào)株)和A1.2(6、15)兩個(gè)子簇群,均為克隆傳播;A2亞簇群中可分為A2.1(2、3、4號(hào)株)和A2.2(9、11、13、18、19號(hào)株)兩個(gè)子簇群,亦均為克隆傳播,B簇群(14、17號(hào)株)亦為克隆傳播。結(jié)論肺炎克雷伯菌耐藥表型與基因型結(jié)果相符,攜帶blaDHA基因?qū)е聦?duì)AmpC型β-內(nèi)酰胺類藥物耐藥,攜帶aac(3)-Ⅱ、aac(6′)-Ⅰb、ant(3″)-Ⅰ、rmtB基因?qū)е聦?duì)氨基糖苷類藥物耐藥,Ⅰ類整合子可能是上述基因的載體,本組菌株存在醫(yī)院感染的可能。
[Abstract]:Objective to investigate the presence of AmpC enzyme producing Klebsiella pneumoniae aminoglycoside resistant gene, AmpC type 尾 -lactamase gene, integron genetic markers and the relationship between the isolates. Methods Twenty strains of Klebsiella pneumoniae isolated from sputum samples of hospitalized patients were collected, all of which were positive for cefxitin. Seven aminoglycoside modifiers and six 16SrRNA methylases were detected by polymerase chain reaction (PCR). Six AmpC type 尾 -lactamases genes and three integron genetic markers were used for sample cluster analysis. Results Aminoglycoside resistant gene and blaDHA,int 鈪，

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