目的研究多药耐药肺炎克雷伯菌(MDRKP)氨基糖苷类药物耐药的遗传学背景。方法收集2008年8月-2010年5月6所医院共47株肺炎克雷伯菌,采用聚合酶链反应(PCR)的方法分析15种氨基糖苷类修饰酶和6种16S rRNA甲基化酶基因。结果该组肺炎克雷伯菌共检出4种氨基糖苷类修饰酶和1种16S rRNA甲基化酶基因,可分为16种阳性检出模式,并发现两株菌携带aac(6′)-Ⅰb基因新亚型[aac(6′)-Ⅰb-hz,美国GenBank登录号:JF901756];其他16种基因未检出。结论携带氨基糖苷类修饰酶和16S rRNA甲基化酶基因,是该组肺炎克雷伯菌对氨基糖苷类药物耐药的主要原因,在多药耐药肺炎克雷伯菌中发现aac(6′)-Ⅰb新亚型[aac(6′)-Ⅰb-hz]为国内外首次报道。
OBJECTIVE To investigate genetic background of drug resistance of multidrug-resistant Klebsiella pneumoniae to aminoglycosides.METHODS From Aug 2008 to May 2010,a total of 47 strains of multidrug-resistant K.pneumoniae were collected from 6 hospitals,then,15 kinds of aminoglycoside modifying enzyme genes and 6 kinds of 16SrRNA methylase genes were analyzed by PCR.RESULTS Four kinds of aminoglycoside modifying enzyme genes and one kind of 16SrRNA methylase gene were detected,which could be classsified to 16 kinds of positive modes.Furthermore,new subtype of aac(6′)-Ⅰb gene(aac(6′)-Ⅰb-hz,GenBank:JF901756) were detected in 2 strains;however,the rest of 16 kinds of genes couldn’t be detected.CONCLUSION Aminoglycoside modifying enzyme genes and 16SrRNA methylase genes play a key role in drug resistance of K.pneumoniae to aminoglycosides.It′s the first report that the new subtype of aac(6′)-Ⅰb gene(aac(6′)-Ⅰb-hz) is detected in multidrug-resistant K.pneumoniae.