孟加拉国产 Qnr 阳性肠杆菌科细菌中喹诺酮耐药 Qnr 基因的检测及其与超广谱β-内酰胺酶和 AmpC β-内酰胺酶基因的关系。

Detection of Quinolone resistance Qnr genes and its association with Extended Spectrum β-lactamase and AmpC β-lactamase genes in Qnr Positive Enterobacteriaceae in Bangladesh.

机构信息

Dr Bithi Das, Assistant Professor, Department of Microbiology, National Institute of cardiovascular Diseases, Dhaka, Bangladesh; E-mail:

出版信息

Mymensingh Med J. 2024 Jan;33(1):183-191.

PMID:38163791

Abstract

This cross-sectional study was conducted to explore quinolone resistant Enterobacteriaceae followed by searching the prevalence of three groups of quinolone resistance genes (QnrA, QnrB and QnrS) from January 2015 to December 2015 at Dhaka Medical College hospital, Bangladesh. Then genes for ESBL and AmpC β-lactamase were detected among Qnr positive strains for better understanding the role of these genes for multiple drug resistance. Total 340 urines, sputum, wound swab and blood samples were collected from DMCH. Total 270(79.41%) Enterobacteriaceae were isolated from 340 samples. Out of 270 Enterobacteriaceae, 225(83.33%) were quinolone (ciprofloxacin) resistant strains. Qnr genes were detected in 141(62.67%) of the 225 quinolone resistant Enterobacteriaceae. Total 187 Qnr genes [84(59.57%) QnrS, 70(49.64%) QnrB and 33(23.40%) QnrA] were detected from 141 quinolone resistant strains. Total 48(34.04%) ESBL producers were detected by DDS test and 47(33.33%) ESBL producers were positive by PCR among 141 Qnr positive strains. QnrA was co-existed with CTX-M-15. QnrB was co-existed with TEM, CTXM-15 and OXA-1. QnrS genes were also associated with TEM, CTX-M-15 and OXA-1. Among 52 cefoxitin resistant Qnr positive strains, 22(42.31%) AmpC β-lactamase producers were detected by Modified three-dimensional test (MTDT) and 45(86.54%) AmpC β-lactamase producers were detected by PCR. QnrA had been identified with DHA, ACC, EBC and CIT while QnrB had been identified with DHA, ACC, EBC and CIT. QnrS had also been co-existed with DHA, ACC, EBC and CIT. The results of this study provided insights into the high proportion of Qnr genes among isolated Enterobacteriaceae. Simultaneous presence of Qnr genes and genes for extended-spectrum β-lactamase or AmpC β-lactamase were observed in multidrug resistant Enterobacteriaceae.

摘要

本横断面研究旨在探索对喹诺酮类药物耐药的肠杆菌科细菌，随后于 2015 年 1 月至 12 月在孟加拉国达卡医学院医院检测了三组喹诺酮类耐药基因（QnrA、QnrB 和 QnrS）的流行情况。然后，在 Qnr 阳性菌株中检测了 ESBL 和 AmpCβ-内酰胺酶基因，以更好地了解这些基因对多重耐药性的作用。共从 DMCH 采集了 340 份尿液、痰、伤口拭子和血液样本。从 340 份样本中分离出 270 株（79.41%）肠杆菌科细菌。在 270 株肠杆菌科细菌中，225 株（83.33%）对喹诺酮类（环丙沙星）耐药。在 225 株对喹诺酮类药物耐药的肠杆菌科细菌中，检测到 141 株（62.67%）携带 Qnr 基因。从 141 株喹诺酮类耐药菌中总共检测到 187 种 Qnr 基因[84 种（59.57%）QnrS、70 种（49.64%）QnrB 和 33 种（23.40%）QnrA]。通过 DDS 试验检测到 48 株（34.04%）ESBL 产酶菌，在 141 株 Qnr 阳性菌株中，通过 PCR 检测到 47 株（33.33%）ESBL 产酶菌。QnrA 与 CTX-M-15 共存。QnrB 与 TEM、CTX-M-15 和 OXA-1 共存。在 52 株头孢西丁耐药的 Qnr 阳性菌株中，通过改良三维试验（MTDT）检测到 22 株（42.31%）AmpCβ-内酰胺酶产酶菌，通过 PCR 检测到 45 株（86.54%）AmpCβ-内酰胺酶产酶菌。QnrA 与 DHA、ACC、EBC 和 CIT 有关，而 QnrB 与 DHA、ACC、EBC 和 CIT 有关。QnrS 也与 DHA、ACC、EBC 和 CIT 共存。本研究结果表明，在所分离的肠杆菌科细菌中，Qnr 基因的比例较高。在多重耐药肠杆菌科细菌中同时存在 Qnr 基因和扩展谱β-内酰胺酶或 AmpCβ-内酰胺酶基因。