左氧氟沙星体外诱导马耳他布鲁杆菌耐药后gyrA基因的变异

目的 探讨马耳他布鲁杆菌对喹诺酮类抗菌药物耐药性的产生机制,为指导临床合理用药提供依据.方法 使用左氧氟沙星分别对6株马耳他布鲁杆菌(Bru1、Bru2、Bru3、Bru4、Bru5、Bru6)进行体外耐药诱导并筛选耐药菌株.采用琼脂稀释法测定左氧氟沙星对6株马耳他布鲁杆菌及诱导耐药菌株的最低抑菌浓度(MIC),采用纸片扩散法(K-B法)测定6株马耳他布鲁杆菌和诱导耐药菌株对喹诺酮类抗菌药物(左氧氟沙星、环丙沙星、洛美沙星、诺氟沙星、氟罗沙星、氧氟沙星)的敏感性.应用PCR技术扩增6株马耳他布鲁杆菌及诱导耐药菌株的gyrA基因,并对获得的基因进行同源性分析及氨基酸序列推导.结果 左氧氟沙星对Bru1,Bru2,Bru3,Bru4,Bru6菌株MIC为0.50 μg/ml,对Bru5菌株为0.25 μg/ml,菌株Bru3、Bru4经左氧氟沙星诱导后转变成耐药菌株,分别命名为LEVR3及LEVR4,其MIC分别为64.00、128.00 μg/ml,与诱导前比较,增加了128倍和256倍,6株马耳他布鲁杆菌对上述喹诺酮类药物均敏感,2株诱导耐药菌株对上述喹诺酮类药物均耐药,并且其GyrA亚单位的喹诺酮耐药性决定区(Quinolone resistance-determing region,QRDR)发生突变:Ala87(GCU)置换为Val(GUU)、Asp91(GAU)置换为Gly(GGU).结论 马耳他布鲁杆菌可在左氧氟沙星短期作用后获得耐药性,诱导的耐药菌株gyrA基因发生突变,且对其他喹诺酮类药物产生交叉耐药.

A study on gyrA mutant in Levofloxacin-resistant Brucella melitensis induced resistant strains in vitro

Objective To study on the drug-resistance mechanism of Brucella resistance to Quinolone antibiotics to guide the selection and use of antimicrobial agents in clinical practice. Methods Six strains of Brucella melitensis(Bru1, Bru2, Bru3, Bru4, Bru5, Bru6) were selected to be induced resistance to levofloxacin in vitro respectively. The MICs of the 6 strains of Brucella melitensis and induced resistant strains were measured by agar dilution method. The sensitivity to Quinolone antibiotics (Levofloxacin, Ciprofloxacin, Lomefloxacin, Norfloxacin, Fleroxacin, Ofloxaein) of 6 strains of Brucella melitensis and induced resistant strains was measured by K-B method. The gyrA of the 6 strains of Brucella melitensis and induced resistant strains was amplified by PCR, then the nucleotide sequence of the genes were analyzed. Results The MICs of Bru1,Bru2,Bru3,Bru4, Bru6 were 0.50 μg/ml and Bru5 was 0.25 μg/ml. The strains Bin3, Bru4 were induced into drug-resistant strains by Levofloxacin, then were named LEVR3 and LEVR4 respectively. The MICs of LEVR3 and LEVR4 were 64,128 μg/ml with 128 and 256 times higher than that of the parental strains. The 6 strains of Brucella melitensis were sensitive to Quinolone antibiotics, LEVR3 and LEVR4 were resistant to Quinolone antibiotics. Neucleotide sequence analysis and comparison of the derived amino acid sequence revealed that Quinolone resistance-determing region of GyrA had a substitution at position Ala87 and Asp91 in laboratory resistant strains. Conclusion The results of in vitro experiments show that acquired resistance of Brucella melitensis strains to Levofloxacin could beinduced when exposed to high level of some antibacterial agents for short term. Two drug-resistant strains occur mutations in gyrA and have cross-resistance to other Quinolones.