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目的了解临床分离肺炎克雷伯菌中qnr基因和I类整合子基因的分布及其耐药特征。方法采用PCR法对45株耐环丙沙星肺炎克雷伯菌进行qnrA、qnrB、qnrS基因筛查并测序,用PCR法检测qnr阳性菌株I类整合子基因,并采用SPSS 13.0和Whonet 5.4软件分析药敏结果及比较。结果 45株肺炎克雷伯菌中,24株(51.1%)细菌检出qnrS基因,未检出qnrA和qnrB基因。20株qnr阳性菌株同时携带I类整合子基因。qnr阳性菌株I类整合子基因携带率显著高于阴性菌株,qnr阳性菌株对阿米卡星、妥布霉素、亚胺培南、哌拉西林/他唑巴坦及头孢哌酮舒巴坦的敏感性较高。结论肺炎克雷伯菌对氟喹诺酮类抗菌药物耐药主要由qnrS引起,qnr阳性株同时携带I类整合子,导致呈现多重耐药性,加强临床耐药监测对控制多重耐药传播有着重要的意义。
Objective To investigate the distribution and drug resistance of qnr gene and class I integron gene in Klebsiella pneumoniae isolated clinically. Methods 45 strains of Klebsiella pneumoniae resistant to ciprofloxacin were screened by PCR and sequenced. The qnrA, qnrB and qnrS genes were screened by PCR, and the type I integron genes of qnr positive strains were detected by PCR. SPSS 13.0 and Whonet 5.4 software Analysis of susceptibility results and comparison. Results Of 45 strains of Klebsiella pneumoniae, 24 (51.1%) bacteria detected qnrS gene and no qnrA and qnrB genes were detected. Twenty strains of qnr positive strains also carry class I integron genes. The carriage rate of class I integron genes of qnr positive strains was significantly higher than that of negative strains. The qnr positive strains were sensitive to amikacin, tobramycin, imipenem, piperacillin / tazobactam and cefoperazone sulbactam The higher the sensitivity. Conclusion The resistance of Klebsiella pneumoniae to fluoroquinolone antibiotics is mainly caused by qnrS. The qnr positive strains carry class I integron at the same time, leading to multiple drug resistance. It is important to strengthen clinical drug resistance monitoring to control multi-drug resistant transmission significance.