碳青霉烯类耐药肺炎克雷伯菌临床分离株中质粒介导的喹诺酮类耐药基因检测

目的：探讨质粒介导的喹诺酮类耐药（PMQR）基因在碳青霉烯类耐药肺炎克雷伯菌（CRKP）临床分离株中的分布情况。方法：收集CRKP29株，聚合酶链反应（PCR）扩增并确定产物基因型。结果：CRKP中PMQR基因检出率为48．3％（14／29），其中qnrB5株，包括qnrB21株、qnrB43株、qnrB101株；qnrS 5株，均为qnrS1；1株同时携带qnrS1和qnrB4；有3株携带aac（6′）-Ib-cr基因。所有PMQR基因阳性菌株均同时携带β-内酰胺酶基因，其中8株同时携带碳青霉烯酶基因，占57．1％（8／14），以blaKPC-2（4／14）及blaNDM-1（3／14）为主。结论：PMQR基因在临床分离的CRKP中较为普遍，以qnr基因为主，且qnr阳性菌株碳青霉烯酶基因携带率较高，均为多重耐药株。

The detection of plasmid mediated quinolone resistance genes in carbapenem-resistant klebsiella-pneumoniae clinical isolates

AIM： To of plasmid mediated investigate distribution quinolone resistance （PMQR） genes in carbapenem-resistant klebsiella-pneumoniae（CRKP） clinical isolates. METHODS： 29 CRKPs were collected , PCR amplifications were performed and the products were sequenced to determine the genetypes. RESULTS： The detection rate of PMQR genes was 48.3 （14/29）, 5 strains carring qnrB gene, including qnrB2 1 strain,qnrB4 3 strain,qnrB10 1 strain; 5 strains carring qnrS1 gene; 1 strain both carring qnrS1 and qnrB4 ; 3 strains carring aac（69-Ib-cr gene. All the 14 strains were positive for PMQR genes harbored β-lactamase genes and 8 strains also harbored carbapenemase genes, accounting for 57.1% （8/14）,blaKPC-2（4/14）and blaNDM- 1（3/14） were the main genotypes of carbapenemase genes. CONCLUSION. PMQR genes are common among the clinical isolates of CRKP, predominantly qnr genotype, and the carring rate of carbapenemase genes is high in qnr-positive isolates, all which are multiple drug-resistant strains.