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目的检测质粒介导的16S rRNA甲基化酶基因rmtA和rmtB,在临床分离的产超广谱β-内酰胺酶(ESBLs)或耐阿米卡星大肠埃希菌和肺炎克雷伯菌中的分布,为临床合理用药提供依据。方法细菌的鉴定和药敏试验采用VITEK-2Compact系统,ESBLs阳性细菌采用双纸片协同试验证实,采用PCR法检测rmtA和rmtB基因。结果 108株细菌均未检测到rmtA基因,肺炎克雷伯菌和大肠埃希菌中rmtB基因的检出率分别为15.4%和1.8%;对于产ESBLs菌株,12.0%的肺炎克雷伯菌包含rmtB基因而大肠埃希菌未检出;20.0%~62.5%的阿米卡星耐药菌株检测到rmtB基因,且rmtB基因阳性菌株同时对庆大霉素和妥布霉素耐药;肺炎克雷伯菌和大肠埃希菌对阿米卡星、庆大霉素及妥布霉素的耐药率分别为15.4%与8.9%、42.3%与62.5%、21.2%与28.6%。结论在肺炎克雷伯菌和大肠埃希菌临床分离株存在16S rRNA甲基化酶基因,且阿米卡星耐药菌rmtB基因阳性率相对高,所有菌株未检出rmtA基因。
Objective To detect the plasmid-mediated 16S rRNA methylase gene rmtA and rmtB in clinically isolated ESBLs-producing or M. amikacin-resistant and Klebsiella pneumoniae The distribution of clinical rational drug use to provide the basis. Methods The bacterial identification and drug susceptibility test were performed on a VITEK-2 Compact system. ESBLs-positive bacteria were confirmed by double paper synergy test. The rmtA and rmtB genes were detected by PCR. Results No rmtA gene was detected in 108 strains of bacteria. The detection rates of rmtB gene in Klebsiella pneumoniae and Escherichia coli were 15.4% and 1.8%, respectively. For Klebsiella pneumoniae producing ESBLs strains, 12.0% of Klebsiella pneumoniae contained rmtB gene was not detected in Escherichia coli; rmtB gene was detected in 20.0% -62.5% amikacin-resistant strains, and rmtB gene-positive strains were resistant to gentamicin and tobramycin simultaneously; The rates of resistance to amikacin, gentamycin and tobramycin in Leishmania and Escherichia coli were 15.4% and 8.9%, 42.3% and 62.5%, 21.2% and 28.6%, respectively. Conclusion The 16S rRNA methylase gene exists in clinical isolates of Klebsiella pneumoniae and Escherichia coli, and the positive rate of rmtB gene in amikacin-resistant bacteria is relatively high. No rmtA gene was detected in all strains.