Study On Fluoroquinolones Related Genes Of Multidrug Resistant Klebsiella Pneumoniae

Klebsiella pneumonia is an important conditional pathogen of enterobacteriaceae. Withwidespread of antimicrobial abuse, klebsiella pneumonia has become one of the most commonpathogen in nosocomial infection. The generation of extended–spectrum-lactamases (ESBLs)underantimicrobial pressure causes multiple drug-resistant bacteria of klebsiella pneumoniaObjective: To investigate the distribution and antimicrobial resistance of klebsiella pneumoniain the five top hospitals of Shanxi province. To study the related genes prevalence of multipledrug-resistance of klebsiella pneumonia fluoroquinolone which could produces ESBLs in severalareas of Shanxi province.Methods：To collect multiple drug-resistant klebsiella pneumonia from those five hospitals fromJanuary2010to December2010and do susceptibility testing with the CLSI recommended standardKirby-Bauer method, and analyzes the data with WHONET5.5software. The related gene ofmultiple drug-resistant klebsiella pneumonia is amplified by PCR method; the positive products areselected to be sequenced and the results are analyzed in Genbank.Results:2516strains of klebsiella pneumoniae were isolated from clinical specimens in2010,40strains of multi-drug resistant klebsiella pneumoniae were isolated from clinical specimens they weremainly distributed in departments of respiration, neurology and intensive care unit (ICU). Thesputum showed highest positive rate (31strains,77.5%); the klebsiella pneumonia showed the lowestresistance rate (12.5%) to imipenem. The resistance rates to antimicrobial agents from low to highwere cefoxitin (60%), amikacin (65%), levofloxaein(67.5%), gentamicin(75%), ceftazidime(77.5%),and ciprofloxacin(77.5%). The resistance rates of other antimicrobial agents were higher than82.5%.According to ESBLS trail,40strains of multiple drug-resistant klebsiella pneumonia werecompletely detected extended–spectrum B-lactamaes. Ciprofloxacin’s resistance rate was77.5%.PCR genetic testing has detected32strains of GyrA mediated by chromosomal genes, including twostrains which are sensitive to ciprofloxacin. Gnr mediated by plasmid has detected8strains blaqnrA1and15strains qnB4.Carbapenem imipenem’s drug resistance rate is12.5%. four KPC enzymes weredetected with the modified Hodge test, and PCR gene detected four blaKPC types.Conclusions: Klebsiella pneumonia is a major pathogenic bacterium in nosocomial infection,the extensive use of antibiotics leads to a rising trend of drug-resistant strains. Pan-resistant andmultiple resistant strains lead to the same strains that carry several genes.Since the phenomenon of multi-drug resistant klebsiella pneumonia is much more serious andthe resistant mechanism is very complex as well, so the monitoring of clinical cases should bestrengthened and the use of antimicrobial agents should be rational so as to reduce the spread of resistant strains.