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目的探讨主动外排系统AcrAB-TolC与肺炎克雷伯菌耐药性的关系。方法运用琼脂稀释法检测抗生素和消毒剂对肺炎克雷伯菌的最小抑菌浓度;PCR扩增肺炎克雷伯菌acrA、acrB和toiC基因,分析AcrAB-TolC与肺炎克雷伯菌耐药的关系。结果肺炎克雷伯菌82.55%检出acrA基因,85.37%检出acrB基因,81.60%检出toiC基因,三基因均阳性,三基因均阴性、部分基因阳性分别占71.22%、9.91%和18.87%;AcrAB-TolC阳性组对阿奇霉素、四环素、氯霉素、苯扎溴胺(1︰49)、碘伏(1︰4)、消佳净(1︰49)的耐药率与AcrAB-TolC缺陷组、AcrAB-TolC阴性组比较差异有统计学意义(P<0.05)。结论肺炎克雷伯菌对阿奇霉素、四环素、氯霉素及中间工作浓度的消毒剂产生耐药性与携带主动外排系统AcrAB-TolC关系密切。
Objective To investigate the relationship between active efflux system AcrAB-TolC and Klebsiella pneumoniae resistance. Methods The minimum inhibitory concentration (MIC) of antibiotics and disinfectants against Klebsiella pneumoniae was determined by agar dilution method. The genes of acrA, acrB and toiC were amplified by PCR, and the resistance of AcrAB-TolC to Klebsiella pneumoniae relationship. Results The gene of acrA was detected in 82.55% of K.pneumoniae, 85.37% of acrB genes were detected in 85.37%, and of toiC gene was detected in 81.60% of all isolates. The three genes were all positive, and the three genes were negative, accounting for 71.22%, 9.91% and 18.87% ; The AcrAB-TolC positive group had no significant difference between AcrAB-TolC resistance rate and azithromycin, tetracycline, chloramphenicol, benzalkonium bromide (1︰49), iodophor (1︰4) Group, AcrAB-TolC negative group was statistically significant difference (P <0.05). Conclusions Klebsiella pneumoniae is resistant to azithromycin, tetracycline, chloramphenicol and disinfectant at intermediate working concentration and is closely related to AcrAB-TolC carrying active efflux system.