Study on the molecular mechanism of carbapenem antibiotic resistance in burns patients infected with Klebsiella pneumoniae / 中国医师进修杂志

ABSTRACT

Objective:To explore the molecular mechanism of carbapenem antibiotic resistance in burns patients infected with Klebsiella pneumoniae.Methods:The patients who were diagnosed with Klebsiella pneumoniae in the burns department of Taizhou Central Hospital (Affiliated Hospital of Taizhou University) from May 2018 to October 2019 were enrolled.Ten carbapenem-resistant Klebsiella pneumoniae (CR-KP) bacterium were isolated, then the degree of resistance of CR-KP bacteria was analyzed.The common resistance genes was detected by polymerase chain reaction (PCR), the existence of resistance genes was verified through plasmid conjugation tests, and the expression of OmpK36 protein in the membrane pores was analyzed.Results:The 10 strains in this study all showed different degrees of drug resistance. The results of PCR showed that all drug resistant bacteria carried the NDM gene, and 4 strains carried the KPC gene. In addition, only a small number of resistant bacteria carried extended-spectrum β-lactamase (ESBLs) genes and AmpC genes. Plasmid conjugation experiments showed that most of the Zygomycetes were resistant to carbapenem antibiotics, and the Western blot results indicated that the protein expression of OMPK36 in the membrane pore of Zygomycetes was decreased.Conclusions:The resistance of CR-KP bacteria in burns patients was mainly caused by plasmid-mediated NDM gene insertion and reduced expression of OMPK36 protein in the membrane pore.