检验医学 ›› 2013, Vol. 28 ›› Issue (11): 1012-1015.DOI: 10.3969/j.issn.1673-8640.2013.11.011

• 临床应用研究.论著 • 上一篇    下一篇

导致阿米卡星双圈耐药肠杆菌科细菌耐药性研究

周万青,沈瀚,宁明哲,张之烽,徐学静,朱宏,曹小利,张葵   

  1. 南京大学医学院附属鼓楼医院检验科,江苏 南京 210008
  • 收稿日期:2013-04-24 出版日期:2013-11-30 发布日期:2013-12-20
  • 通讯作者: 张葵,联系电话:025-83106666-60666。
  • 作者简介:周万青,男,1981年生,硕士,主管技师,主要从事微生物检验及耐药机制研究。

Study on the double-circle drug resistance to amikacin in Enterobacteriaceae

ZHOU Wanqing, SHEN Han, NING Mingzhe, ZHANG Zhifeng, XU Xuejing, ZHU Hong, CAO Xiaoli, ZHANG Kui.   

  1. Department of Clinical Laboratory, Drum Tower Hospital, Nanjing University School of Medicine,Jiangsu Nanjing 210008,China
  • Received:2013-04-24 Online:2013-11-30 Published:2013-12-20

摘要:

目的 探讨临床分离的纸片扩散法药物敏感性试验对阿米卡星(AMK)呈双圈耐药的肠杆菌科细菌相关携带基因及药物诱导对耐药基因mRNA表达量的影响。方法 收集纸片扩散法药物敏感性试验对AMK呈双圈耐药的大肠埃希菌(编号Eco85)和肺炎克雷伯菌(编号Kpn110)各1株;纸片诱导法探讨耐药表型的改变;聚合酶链反应(PCR)扩增氨基糖苷类修饰酶基因、整合子及其可变区以及16SrRNA甲基化酶基因;逆转录PCR分析armA基因在AMK诱导前后菌株中的表达情况;接合试验探讨耐药基因的可传递性。结果 Eco85和Kpn110分别在第10代和第16代诱导后转变为双圈消失;2株菌均扩增出Ⅰ类整合子基因,可变区分别携带aadA5-dfra17和aadA2-dfrA12基因盒,未扩增出Ⅱ和Ⅲ类整合子基因;Eco85扩增出aac(6)-Ⅰ基因,而Kpn110扩增出ant(3″)-Ⅰ基因;Eco85和Kpn110均扩增出armA基因,基因测序未发现突变,未检出rmtB基因;经AMK诱导后菌株armA基因mRNA表达量明显上升;接合试验未获成功。结论 大肠埃希菌和肺炎克雷伯菌对AMK呈双圈耐药可能与16SrRNA甲基化酶armA基因的诱导表达相关。

关键词: 双圈耐药, 诱导, armA基因, 阿米卡星, 肠杆菌科细菌, 逆转录-聚合酶链反应

Abstract:

Objective To investigate the double-circle drug resistance gene to amikacin (AMK) in Entero-bacteriaceae by disk diffusion methodand to study the influence on the expression level of resistance gene mRNA. Methods One strain of Escherichia coli (Eco85) and one strain of Klebsiella pneumoniae (Kpn110) which showed double-circle drug resistance to AMK were collected, and the resistance phenotype change was analyzed by disk diffusion method. Polymerase chain reaction (PCR) was performed for aminoglycoside modification genes, integronsand 16S rRNA methylase gene. The armA gene expression levels among strains induced and non-induced by AMK were studied by reverse transcription PCR. Transmissibility of the resistant gene was carried out by conjugation method. Results The double-circle resistance phenotype was changed to complete resistance at the tenth and sixteenth for Eco85 and Kpn110, respectively. The 2 strains were positive for integron geng Ⅰ, Eco85 and Kpn110 contained aadA5-dfra17 box and aadA2-dfrA12 box, respectively. The 2 strains were positive for integron gene Ⅱ and Ⅲ. Eco85 was positive for aac(6)-Ⅰ gene, and Kpn110 was positive for ant (3″)-Ⅰ gene. Eco 85 and Kpn 110 were positive for armA gene, and there was no mutation in gene sequencing and no rmt B gene. The expression level of armA gene mRNA was significantly up-regulated when the strains were induced by AMK. The conjugation test was failed. Conclusions The double-circle drug resistance to AMK in Escherichia coli and Klebsiella pneumoniae may associate with the induction expression of 16S rRNA methylase armA gene.

Key words: Double-circle drug resistance, Induction, armA gene, Amikacin, Enterobacteriaceae, Reverse transcription polymerase chain reaction

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