Lim King Ting, Yeo Chew Chieng, Md Yasin Rohani, Balan Ganeswrie, Thong Kwai Lin
Institute of Biological Science, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Faculty of Agriculture and Biotechnology, Universiti Darul Iman Malaysia, 20400 Kuala Terengganu, Malaysia.
J Med Microbiol. 2009 Nov;58(Pt 11):1463-1469. doi: 10.1099/jmm.0.011114-0. Epub 2009 Jul 9.
The emergence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae poses a serious antibiotic management problem as resistance genes are easily transferred from one organism to another. Fifty-one strains of K. pneumoniae isolated from sporadic cases in various hospitals throughout Malaysia were analysed by antimicrobial susceptibility testing, PCR detection of ESBL-encoding genes and DNA fingerprinting. Although 27 of the 51 K. pneumoniae strains were MDR (i.e. resistant to three or more classes of antibiotics), the majority of the strains (98 %) were sensitive to imipenem. PCR detection using ESBL gene-specific primers showed that 46 of the K. pneumoniae strains harboured bla(SHV), 19 harboured bla(CTX-M), 5 harboured bla(OXA-1) and 4 harboured bla(TEM-1). Class 1 integron-encoded intI1 integrase was detected in 21 of the 51 K. pneumoniae strains and amplification of the integron 5'CS region showed the presence of several known antibiotic resistance gene cassettes of various sizes. Results of conjugation and transformation experiments indicated that some of the ESBL-encoding genes (i.e. bla(SHV), bla(CTX-M) and bla(TEM-1)) were transmissible and were likely plasmid-encoded. DNA fingerprinting using PFGE and PCR-based methods indicated that the 51 K. pneumoniae strains were genetically diverse and heterogeneous.
产超广谱β-内酰胺酶（ESBL）和多重耐药（MDR）的肺炎克雷伯菌的出现带来了严重的抗生素管理问题，因为耐药基因很容易从一种生物体转移到另一种生物体。对从马来西亚各地不同医院的散发病例中分离出的51株肺炎克雷伯菌进行了抗菌药敏试验、ESBL编码基因的PCR检测和DNA指纹分析。虽然51株肺炎克雷伯菌中有27株为多重耐药菌（即对三类或更多类抗生素耐药），但大多数菌株（98%）对亚胺培南敏感。使用ESBL基因特异性引物进行的PCR检测表明，46株肺炎克雷伯菌携带bla(SHV)，19株携带bla(CTX-M)，5株携带bla(OXA-1)，4株携带bla(TEM-1)。在51株肺炎克雷伯菌中的21株中检测到1类整合子编码的intI1整合酶，整合子5'CS区域的扩增显示存在几种不同大小的已知抗生素耐药基因盒。接合和转化实验结果表明，一些ESBL编码基因（即bla(SHV)、bla(CTX-M)和bla(TEM-1)）是可传播的，并且可能是质粒编码的。使用脉冲场凝胶电泳（PFGE）和基于PCR的方法进行的DNA指纹分析表明，这51株肺炎克雷伯菌在基因上是多样的且异质的。
