耐美洛培烯肺炎克雷伯菌bla-IMP和bla-VIM基因在尿路感染中的表达研究

Shahad Tariq Hamad, Kais Kassim Ghaima
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摘要

背景:碳青霉烯耐药肠杆菌科的出现,特别是肺炎克雷伯菌的出现,引起与多药耐药菌株相关的感染,是一个主要的临床和公共卫生问题。目的:评价美罗培南存在和不存在时bla-IMP和bla-VIMgenes的表达水平。方法:从2020年11月至2021年3月在伊拉克巴格达医院采集的250份患者尿液样本中分离出80株肺炎克雷伯菌。采用微量稀释法测定菌株的最低抑菌浓度(mic)。Real-time PCR检测bla-IMP和bla- vim耐药基因的存在。采用实时荧光定量PCR检测美罗培南存在和不存在情况下blah-IMP和bla-VIM基因的表达水平。结果:本研究结果显示,美罗培南存在时,耐药菌株blaIMP和bla-VIM的高表达量增加,其中bla-VIM基因表达倍数范围为1.3 ~ 8.3,而forbla-IMP基因表达倍数范围为1.5 ~ 8.4。结论:综上所述,肺炎克雷伯菌治疗中过量使用美罗培南和亚胺培南抗生素可能导致该菌对碳青霉烯类和头孢菌素的耐药性增加,并且肺炎克雷伯菌分离株对美罗培南的耐药性与bla-IMP和bla- vim2个基因的基因表达存在相关性。关键词:碳青霉烯类耐药性,肺炎克雷伯菌,bla-IMP, bla-VIM,基因表达,UTI。
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Study the Gene Expression of bla-IMP and bla-VIM Genes In Meropenem-resistant Klebsiella pneumoniae Isolated from Urinary Tract Infections
Background: The emergence of carbapenem-resistant Enterobacteriaceae, especially Klebsiella pneumoniae, which causes infection associated with multidrug-resistant strains, is a primary clinical and public health concern. Objectives: This study aimed to evaluate the expression level of bla-IMP and bla-VIM genes in the presence and absence of meropenem antibiotics. Methods: Eighty K. pneumoniae isolates were obtained from 250 urine samples collected from patients in Baghdad Hospitals, Iraq, from November 2020 to March 2021. The minimum inhibitory concentrations (MICs) were measured for the isolates by microdilution method. Real-time PCR detected the presence of bla-IMP and bla-VIM resistance genes. The blah-IMP and bla-VIM gene expression levels were measured by real-time PCR in the presence and absence of meropenem antibiotics. Results: The results of this study showed that the higher expression level of blaIMP and bla-VIM increased in resistant strains in the presence of meropenem, where the range of fold for gene expression of bla-VIM was 1.3 to 8.3, while for bla-IMP gene was 1.5 to 8.4. Conclusion: In conclusion, the overuse of meropenem and imipenem antibiotics in the treatment of K. pneumoniae may lead to an increase in the resistance of this species to carbapenems and cephalosporins, and There was a correlation between the meropenem resistance in K. pneumoniae isolates and the gene expression of the tow genes bla-IMP and bla-VIM Keywords: Carbapenem Resistance, Klebsiella pneumoniae, bla-IMP, bla-VIM, Gene expression, UTI.
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