Research Imipenem Induced Resistant Klebsiella Pneumoniae And Resistance Mechanism

Objectives: Through the analysis of imipenem resistant pneumonia grams to explore the role of AmpC and ompK35 protein in imipenem resistant pneumonia Klebsiella resistant mechanism characteristic of drug resistance in Klebsiella pneumoniae.Klebsiella pneumoniae(KPN)is isolated from clinical and hospital infection of one of the most important pathogens,in 1893 from lobar pneumonia patients of lung tissue was first isolated can cause pneumonia,urinary tract infection,septicemia,wound infections,meningitis and other diseases,has become an important pathogen of nosocomial infection.Due to the extensive use of antimicrobial agents,the pneumonia Klebsiella pneumoniae resistance is very common and carbapenem,antibiotics is the treatment of multi drug resistant pneumonia grams of Klebsiella pneumoniae is the most potent antibiotics,including imipenem,meropenem and so on.However,with the use of carbon and the use of antibiotics,many regions of the world have been reported to have been infected with Klebsiella pneumoniae.In China,the study imipenem induced pneumonia Klebsiella resistant reported is not a lot,so this paper have certain innovation.Methods:1 Collecting samplesA total of 240 strains of Klebsiella pneumoniae isolated from clinic.In our hospital,the culture of the specimens were mainly concentrated in the intensive care unit,Department of Neurosurgery,Department of internal medicine,Department of respiration,Department of Urology,and so on.Because of the large number of antibiotics,the identification rate and drug resistance rate of Klebsiella pneumoniae were higher than that of several endemic areas.2 Detection method and monitoring indexThe first,K-B method was used for determination of 10 kinds of commonly used antibiotics resistance,piperacillin,imipenem and gentamicin,aztreonam and ceftazidime ceftazidime,levofloxacin,amikacin,cefotaxime cefepime,ciprofloxacin and slime molds B is selected drug and extract of imipenem resistant pneumonia Klebsiella strains.The second,using agar dilution method.The minimum inhibitory concentration of imipenem,screening of Klebsiella pneumoniae resistance to imipenem.The third,type analysis of imipenem resistant Klebsiella pneumoniae producing beta lactamase using the method of the three-dimensional experiment.ompK35 gene were detected by PCR method.Plasmid carrying AmpC gene were detected by multiplex PCR.Fluorescent quantitative RT-PCR method was used to detect the expression of ompK35 gene,and the expression of Amp C gene was detected by RT-PCR method in AmpC.3 Statistical methodsAll data show that the average number of standard deviation.Single factor analysis of variance and t test for group differences.When a value is less than 0.05,the difference is significant.Results:1 240 strains of Klebsiella pneumoniae was selected clinical commonly used antibiotics piperacillin,imipenem and gentamicin,aztreonam and ceftazidime ceftazidime,levofloxacin,amikacin,cefotaxime cefepime,ciprofloxacin and slime prime B and other 10 kinds of drug resistance experiment.The results showed pneumonia Klebsiella pneumoniae resistant to these drugs rate from high to low as follows: 39.18%,35.36 34.45%,32.18% 30.36% and 28.72% and 27.39%,24.90% and 13.72% and 0%.2 A total of 48 strains of Klebsiella pneumoniae were detected in 240 strains of beta the detection rate of 20%(48/240).Among them,25 strains(52.08%)produced AmpC enzyme,4(8.33%),and 11(22.92%)of ESBL producing strains,and 3(6.25%)of Amp C and 5(10.42%)of the production of the enzyme.The AmpC activity of 7 strains of bacteria could be hydrolyzed by IMP.3 PCR,multiplex PCR and fluorescence quantitative RT-PCR to detect the IMP resistance of Klebsiella pneumoniae strains showed that the gene content of AmpC was increased in different levels,which increased at least 4.44 times,and increased by 354.59 times.90 strains of KP,ompK35,44.44%(IRKp),50(40/90),55.56%(50/90),were detected by the gene.4 Fluorescence quantitative RT-PCR to IRKp ompK35 gene expression of protein content detection,25 strains produced AmpC enzyme KP strains,12 strains ompK35 gene expression decreased amounts.13 strains ompK35 gene expression of normal amount;in 25 strains producing Amp C enzyme KP strains in weak hydrolysis of IMP strains have 7 strains,the AmpC enzyme gene expression was significantly increased significantly,the 5 strains of bacteria also accompanied by ompK35 gene expression amount decreased.Conclusion:1 Imipenem induced by Klebsiella pneumoniae resistant2 The presence of AmpC is an important factor in KP resistance to IMP,and it may play an important role in the mechanism of resistance.3 OmpK35 protein expression is one of the important causes of KP resistance to IMP.