下呼吸道感染来源铜绿假单胞菌毒力基因与氟喹诺酮类药物的耐药性研究

发布时间：2018-03-25 11:46

本文选题：铜绿假单胞菌　切入点：exoS基因　出处：《中国人兽共患病学报》2017年01期

【摘要】：目的检测下呼吸道感染患者分离的铜绿假单胞菌毒力基因exoS、exoU表达及与氟喹诺酮耐药性的相关性。方法收集2015年10月至2016年3月住院患者痰标本中分离的铜绿假单胞菌,以液体稀释法测定药物敏感性;PCR法扩增exoS、exoU基因。结果检出铜绿假单胞菌46株,exoS、exoU基因阳性率分别为86.96%(40/46)和69.57%(32/46),检出率最高的基因型是exoS+/exoU+(60.87%,28/46)。其中36.96%(17/46)为多重耐药菌(MDR)。氟喹诺酮不敏感(FQNS)菌株78.95%(15/19)为MDR,89.47%(17/19)表达exoU基因,明显高于氟喹诺酮敏感(FQ-S)菌株(P0.05)。与FQ-S菌株相比,FQ-NS菌株耐药严重,对氨曲南和头孢吡肟耐药率高达70%以上,对美罗培南和亚胺培南耐药率高于50%。耐药率较低的药物有多黏菌素B(10.53%,2/19)、阿米卡星(10.53%,2/19)、头孢他啶(15.79%,3/19)和庆大霉素(21.05%,4/19)。结论下呼吸道感染铜绿假单胞菌毒力基因exoS、exoU阳性率较高,以exoS+/exoU+基因型为主。与FQ-S比较,FQ-NS菌株耐药性更为严重,exoU阳性率更高,提示临床应加强毒力基因及耐药性监测。
[Abstract]:Objective to detect the expression of the virulence gene exoSnexoU of Pseudomonas aeruginosa isolated from patients with lower respiratory tract infection and its correlation with fluoroquinolone resistance. Methods Pseudomonas aeruginosa isolated from sputum samples of hospitalized patients from October 2015 to March 2016 were collected. ExoSnexoU gene was amplified by liquid dilution assay. Results the positive rate of exoSexoU gene was 86.96% 40 / 46 in 46 strains of Pseudomonas aeruginosa and 69.57% in 32 / 46%, respectively. The highest detection rate was exoS / exoU / 60.87 / 28 / 46 / 460.36.96% / 1746). Nordone insensitive strain 78.95% 15 / 19) expressed exoU gene for MDR 89.47% 17 / 19). Compared with FQ-S strain, FQ-NS strain was significantly more resistant to aztreonam and cefepime, and the resistance rate to aztreonam and cefepime was more than 70%. The drug resistance rates to meropenem and imipenem were higher than 50. The drug with low drug resistance rate were polymyxine 10. 53 / 2 / 19, amicacin 10. 53% 2 / 19, ceftazidime 15. 79% 3 / 19) and gentamycin 21. 05% 4 / 19. Conclusion the positive rate of exo SexoU gene of Pseudomonas aeruginosa in lower respiratory tract infection was higher. The exoS / exoU genotype was the main genotype. Compared with FQ-S, the drug resistance of FQ-NS strain was more serious, and the positive rate of FQ-NS strain was higher than that of FQ-S, suggesting that the virulence gene and drug resistance monitoring should be strengthened in clinic.
【作者单位】：吉林医药学院检验学院;吉林省人民医院检验科;
【基金】：江苏省检验医学重点实验室开放基金项目(No.JSKLM-2014-016)~~
【分类号】：R56;R446.5

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