本研究旨在确定约旦北部肺炎克雷伯菌临床分离株中的表型和基因型氨基糖苷类和喹诺酮类非敏感性以及氨基糖苷类修饰酶和质粒介导的喹诺酮类耐药基因的患病率。使用Kirby-Bauer圆盘扩散法测试肺炎克雷伯菌分离株(n=183)的抗微生物敏感性。双盘协同试验用于检测超广谱β-内酰胺酶表型。聚合酶链反应用于检测编码氨基糖苷修饰酶(aac(3')-II,aac(6')-II,aac(6\')-Ib,蚂蚁(3“)-I,aph(3')-VI,arma,和rmtB),和质粒介导的喹诺酮耐药(qnrA,qnrB,qnrC,qnrD,qnrS,acc(6\')-Ib-cr,qepA,和oqxAB)基因。使用多位点序列分型来阐明所选分离株的遗传多样性。对氨基糖苷类和喹诺酮类的非敏感性百分比分别为65.0%和61.7%,分别。最常见的氨基糖苷类修饰酶基因是ant(3″)-I,占73.8%,其次是aac(6')-Ib,占25.1%,aac(3')-II为17.5%,aph(3')-VI为12.0%,arma为9.8%,和rmtB为0.5%。在分离物中未检测到Aac(6')-II。最常见的质粒介导的喹诺酮耐药基因是oqxAB,占31.7%,其次是qnrS,为26.2%,qnrB为25.7%,ac(6')-Ib-cr为25.7%。QnrA,qnrD,qebA,在分离株中未检测到qnrC。AAC(3')-II,aac(6\')-Ib,aph(3')-VI,arma,qnrB,qnrS,和acc(6')-Ib-cr与氨基糖苷类药物的非敏感性显着相关,喹诺酮类药物,和β-内酰胺。在随机选择的27株肺炎克雷伯菌中,最常见的序列类型是ST2096,其次是ST348和ST1207.总的来说,观察到19种序列类型,证实了分离株之间高水平的遗传多样性。发现了对所研究的抗微生物剂不敏感的高百分比,并且与几种抗性基因的存在有关。应定期进行类似的研究,以监测分离株耐药表型和基因型流行率的变化。
This study aimed to identify phenotypic and genotypic aminoglycoside and quinolone non-susceptibility and the prevalence of aminoglycoside-modifying enzymes and plasmid-mediated quinolone resistance genes among K. pneumoniae clinical isolates from northern Jordan. K. pneumoniae isolates (n = 183) were tested for antimicrobial susceptibility using the Kirby-Bauer disk diffusion method. The double-disk synergy test was used for the detection of the extended-spectrum beta-lactamase phenotype. Polymerase chain reaction was used to detect genes encoding aminoglycoside-modifying enzyme (aac (3\')-II, aac (6\')-II, aac (6\')-Ib, ant (3″)-I, aph (3\')-VI, armA, and rmtB), and plasmid-mediated quinolone resistance (qnrA, qnrB, qnrC, qnrD, qnrS, acc(6\')-Ib-cr, qepA, and oqxAB) genes. Multi-locus sequence typing was used to elucidate the genetic diversity of selected isolates. The non-susceptibility percentages to aminoglycosides and quinolones were 65.0 % and 61.7 %, respectively. The most frequent aminoglycoside-modifying enzyme gene was ant (3″)-I at 73.8 %, followed by aac (6\')-Ib at 25.1 %, aac (3\')-II at 17.5 %, aph (3\')-VI at 12.0 %, armA at 9.8 %, and rmtB at 0.5 %. Aac (6\')-II was not detected among the isolates. The most frequent plasmid-mediated quinolone resistance gene was oqxAB at 31.7 %, followed by qnrS at 26.2 %, qnrB at 25.7 %, and aac(6\')-Ib-cr at 25.7 %. QnrA, qnrD, qebA, and qnrC were not detected among the isolates. Aac (3\')-II, aac (6\')-Ib, aph (3\')-VI, armA, qnrB, qnrS, and acc(6\')-Ib-cr were significantly associated with non-susceptibility to aminoglycosides, quinolones, and beta-lactams. Among 27 randomly selected K. pneumoniae isolates, the most common sequence type was ST2096, followed by ST348 and ST1207. Overall, 19 sequence types were observed, confirming a high level of genetic diversity among the isolates. High percentages of non-susceptibility to the studied antimicrobials were found and were associated with the presence of several resistance genes. Similar studies should be periodically carried out to monitor changes in the prevalence of resistance phenotypes and genotypes of isolates.