汪群水, 周学琴, 李丽民. 从患者胆汁分离的大肠埃希菌中质粒介导的氟喹诺酮类耐药基因的检测[J]. 疾病监测, 2015, 30(6): 493-496. DOI: 10.3784/j.issn.1003-9961.2015.06.015
引用本文: 汪群水, 周学琴, 李丽民. 从患者胆汁分离的大肠埃希菌中质粒介导的氟喹诺酮类耐药基因的检测[J]. 疾病监测, 2015, 30(6): 493-496. DOI: 10.3784/j.issn.1003-9961.2015.06.015
WANG Qun-shui, ZHOU Xue-qin, LI Li-min. Study of plasmid-mediated quinolone resistance gene in Escherichia coli strain isolated from bile[J]. Disease Surveillance, 2015, 30(6): 493-496. DOI: 10.3784/j.issn.1003-9961.2015.06.015
Citation: WANG Qun-shui, ZHOU Xue-qin, LI Li-min. Study of plasmid-mediated quinolone resistance gene in Escherichia coli strain isolated from bile[J]. Disease Surveillance, 2015, 30(6): 493-496. DOI: 10.3784/j.issn.1003-9961.2015.06.015

从患者胆汁分离的大肠埃希菌中质粒介导的氟喹诺酮类耐药基因的检测

Study of plasmid-mediated quinolone resistance gene in Escherichia coli strain isolated from bile

  • 摘要: 目的 分析浙江省衢州市开化县第二人民医院消化内科胆汁分离的大肠埃希菌的耐药特点并调查质粒介导的喹诺酮类耐药基因的分布情况和流行特点。方法 收集该院消化内科患者2011年1月至2013年6月分离的大肠埃希菌724株,均为非重复性菌株,采用全自动微生物分析仪器VITEK 2 COMPACT进行细菌鉴定及药物敏感性分析,采用聚合酶链反应 (polymerase chain reaction,PCR)分析质粒介导的氟喹诺酮类耐药基因(plasmid-mediated quinolone resistance genes, PMQR) 如qnrA、qnrB、qnrS、aac(6')-Ib-cr和qepA 基因的流行特点。结果 胆源性大肠埃希菌的构成比达18.65%(135/724),其对环丙沙星和左氧氟沙星的耐药率高达61.5%(83/135)和55.6%(75/135),未检出碳青霉烯类抗生素耐药菌株;PCR检测PMQR基因结果显示:135株胆源性大肠埃希菌中,121株 (89.63%) qnrA1 基因阳性,45株(33.33%) qnrB4 基因阳性,32株 (23.70%) qnrB6 基因阳性,43株(31.85%) qnrS1 基因阳性,34株(25.19%) aac(6')-Ib-cr 基因阳性菌株,未检出qepA基因;其中45株(33.33%)同时携带 qnrA1、qnrB4 基因,32株(23.70%)同时携带 qnrA1、qnrB6, 25株(18.52%)同时携带 qnrA1、qnrB4、qnrS1, 21株(15.56%)同时携带 qnrA1、qnrB4、qnrS1、acc(6')-Ib-cr, 12株(100%)同时携带 qnrA1、qnrB6、qnrS1、acc(6')-Ib-cr, 且环丙沙星和左氧氟沙星的耐药率随着PMQR基因组合种类的增多而增多。结论 消化内科胆汁分离的大肠埃希菌氟喹诺酮类抗生素耐药严重,耐药基因主要以 qnrA1为主,qnrB4和qnrB6 次之,且存在多种PMQR基因组合形式,这些潜在播散的氟喹诺酮耐药基因对于临床胆道感染的治疗有很大的挑战。

     

    Abstract: Objective To investigate the drug resistance of Escherichia coli isolated from bile and the distribution of its plasmid-mediated quinolone resistance genes (PMQR) in No. 2 People's Hospital of Kaihua County. Methods A total of 724 strains of E. coli were isolated from clinical specimens from department of gastroenterology in this hospital from January 2011 to June 2013, the identification of the strains were performed with automated microbial analysis instruments VITEK 2 COMPACT. The PMQR genes qnrA, qnrB, qnrS, aac(6')-Ib-cr and qepA were detected by using PCR. Results Among the 724 E. coli strains isolated, 135 were isolated from bile, accounting for 18.65%. All the 135 E. coli strains showed 100% sensitivity to carbapenem, and the resistant rates to ciprofloxacin and levofloxacin were 61.5% (83/135) and 55.6% (75/135) respectively. The PCR results revealed that 121 qnrA gene positive strains, 77 qnrB gene positive strains, 43 qnrS gene positive strains and 34 aac(6')-Ib-cr gene positive strains were detected. No qepA gene positive strains were detected. Among these strains, 45 (33.33%) co-carried qnrA1 and qnrB4 genes, 32 (23.70%) co-carried the qnrA1 and qnrB6 genes, 25 (18.52%) co-carried qnrA1, qnrB4 and qnrS1 genes, 21 (15.56%) co-carried qnrA1, qnrB4, qnrS1 and acc (6')-Ib-cr genes and 12 (100%) co-carried qnrA1, qnrB6, qnrS1, and acc (6')-Ib-cr genes. In addition, the resistant rates to ciprofloxacin and levofloxacin increased with the numbers of PMQR gene types. Conclusion E. coli strains isolated from bile were seriously resistant to fluoroquinolone antibiotics. qnrA1 gene was the major PMQR gene in this study, followed by the qnrB4 and qnrB6. The spread of fluoroquinolone resistant genes poses the challenge to clinical treatment of biliary tract infection in gastroenterology department.

     

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