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Identification of Klebsiella pneumoniae strains harboring inactive extended-spectrum beta-lactamase antibiotic-resistance genes

摘要Background The extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae has increasingly become a major contributor to nosocomial infections and can exhibit multiple antibiotic resistance.Previous studies have focused on the resistance genes in ESBL-producing strains,and the resistance-associated genetic environment of non-ESBL-producing strains has been ignored until now.Here,we investigated the occurrence and characteristics of non-ESBL-producing K.pneumoniae,which potentially carries unexpressed resistance genes.Methods K.pneumoniae strains were collected from five medical institutions in China from February 2010 to August 2013.The VITEK-2 ESBL detection system was used as a primary screen to identify the ESBL-producing phenotype,and the three primary types of ESBL-associated genes (CTX,SHV,and TEM) were detected by polymerase chain reaction (PCR) to confirm the strains presenting with a non-ESBL-producing phenotype.mRNA expression in the non-ESBL-producing strains was further screened by reverse-transcription PCR (RT-PCR) to validate their transcriptional efficiency.Results Out of 224 clinically isolated antibiotic-sensitive K.pneumoniae strains with a non-ESBL-producing phenotype,5 (2.2%) were identified to carry inactivated ESBL blaSHV genes with intact upstream promoter regions and resistance gene sequences.Interestingly,three of the five antibiotic-sensitive K.pneumoniae strains containing ESBL blaSHV genes still exhibited mRNA transcription of blasHv,while the other two exhibited no mRNA transcription.Conclusion These findings suggest that inactivated ESBL genes exist in non-ESBL-producing antibiotic-sensitive K.pneumoniae strains,which have the potential to transform the strain into an ESBL phenotype if an inappropriate application or overdose of antibiotics is implemented during clinical management.

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作者单位 Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China [1] Institute of Clinical Pharmacology, Peking University First Hospital,Peking University, Beijing 100034, China [2] Department of Respiratory Medicine, the Second Affiliated Hospital to Dalian Medical University, Dalian, Liaoning 116023, China [3] Department of Respiratory Medicine, First Hospital of Tsinghua University, Beijing 100016, China [4] Department of Respiratory Medicine, the Central Hospital of China Aerospace Corporation, Beijing 100049, China [5] Department of Respiratory Medicine, Fujian Provincial Hospital,Fuzhou, Fujian 350001, China [6]
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DOI 10.3760/cma.j.issn.0366-6999.20140628
发布时间 2014-10-09(万方平台首次上网日期,不代表论文的发表时间)
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中华医学杂志(英文版)

中华医学杂志(英文版)

2014年127卷17期

3051-3057页

SCIMEDLINEISTICCSCDCABP

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