耐碳青霉烯类铜绿假单胞菌整合子检测与耐药性分析

发布时间：2018-06-19 17:50

本文选题：铜绿假单胞菌 + 整合子　；参考：《中华医院感染学杂志》2016年10期

【摘要】：目的了解医院耐碳青霉烯类铜绿假单胞菌中整合子的分布及可变区中基因盒的类型与细菌耐药性的关系,为控制医院感染提供依据。方法采用聚合酶链反应(PCR)扩增和琼脂糖凝胶电泳的方法对宁波市医疗中心李惠利医院2012-2014年临床分离的336株耐碳青霉烯铜绿假单胞菌第1、2类整合子进行筛查,并对整合子阳性菌株的可变区序列进行测序分析;采用WHONET5.6和SPSS18.0软件对数据进行统计分析。结果 336株临床菌株中第1类整合子阳性菌株共有42株,阳性率为12.5%;没有筛选到第2类整合子阳性菌株;42株整合子阳性菌株中,23株可变区基因盒为aadA6△-orfd,10株可变区基因盒为aadA6△-ISPa21-aadA6△-orfd,为氨基糖苷类抗菌药物的耐药基因,其余9株可变区未整合基因盒;整合基因盒aadA6△-orfd菌株组阿米卡星、庆大霉素、妥布霉素的耐药率均明显高于未整合基因盒菌株组(P0.05);而整合基因盒aadA6△-ISPa21-aadA6△-orfd菌株组阿米卡星、庆大霉素、妥布霉素的耐药率介于上述两组之间;42株整合子阳性菌株对阿米卡星、哌拉西林/他唑巴坦、庆大霉素、头孢吡肟、头孢他啶、妥布霉素和左氧氟沙星的耐药率分别为57.1%、73.8%、85.7%、80.9%、95.2%、83.3%和88.1%,均显著高于整合子阴性菌株(P0.01)。结论耐碳青霉烯类铜绿假单胞菌整合子的携带率相对较低,可变区所携带的耐药基因主要为氨基糖苷类抗菌药物的耐药基因,基因盒与菌株的耐药性呈高度相关,整合子可能还存在着其他机制参与耐药表型的产生。
[Abstract]:Objective to investigate the distribution of integrons in carbapenem resistant Pseudomonas aeruginosa and the relationship between gene cassette types in variable regions and bacterial resistance in hospital, and to provide evidence for the control of nosocomial infection. Methods the PCR amplification and agarose gel electrophoresis were used to screen 336 strains of Pseudomonas Carbicilli resistant to Pseudomonas Carbicilli from 2012 to 2014 in Li Huili Hospital, Ningbo Medical Center. The variable region sequence of integron positive strain was sequenced and the data were analyzed by WHONET5.6 and SPSS 18.0 software. Results there were 42 integron positive strains in 336 clinical strains. The positive rate was 12.5. Of the 42 integron positive strains of class 2, 23 of them were aadA6 -orfdD, aadA6 -ISPa21-aadA6 -orfd, which were resistant to aminoglycoside antibiotics, the positive rate was 12.5%, and the positive rate was 12.5.The results showed that the variable region gene cassette of 23 strains was aadA6 -ISPa21-aadA6 -orfd, which was the resistant gene of aminoglycoside antibiotics. The drug resistance rates of Amikacin, gentamycin and tobramycin in the aadA6 -orfd group were significantly higher than those in the unintegrated gene box group (P0.05), while in the aadA6 -ISPa21-aadA6-orfd group, the drug resistance rates were significantly higher than those in the unintegrated gene box group. The resistance rates of gentamicin and tobramycin were between the above two groups. 42 integron positive strains were resistant to amikacin, piperacillin / tazobactam, gentamicin, cefepime, ceftazidime. The drug resistance rates of tobramycin and levofloxacin were 57.1and 85.73.8and 85.70.95. 2% and 88. 1%, respectively, which were significantly higher than those of integron negative strains (P 0.01). Conclusion the carrier rate of carbapene-resistant Pseudomonas aeruginosa integron is relatively low. The resistant gene of variable region is mainly aminoglycoside antibiotic resistance gene, and the gene box is highly correlated with the drug resistance of the strain. Integrons may also have other mechanisms involved in the production of drug-resistant phenotypes.
【作者单位】：宁波市医疗中心李惠利医院检验科;浙江省人民医院检验科;
【基金】：国家自然科学基金资助项目(81101291) 浙江省自然科学基金资助项目(Y2110743)
【分类号】：R440

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