1例肺炎患者利奈唑胺耐药粪肠球菌定植规律研究

发布时间：2018-03-18 20:46

本文选题：粪肠球菌　切入点：利奈唑胺　出处：《中国热带医学》2014年11期 　论文类型：期刊论文

【摘要】：目的研究1例肺部感染患者体内利奈唑胺耐药粪肠球菌株突变以及定植特点。方法从1例反复发作肺炎(1年内反复发作5次)的急性白血病患者的气管分泌物中分离出10株粪肠球菌株,菌株的MIC值通过E-test测定,经PCR扩增细菌4个拷贝23S r RNA基因V区基因,测序分析突变位点,通过脉冲场凝胶电泳(PFGE)观察分离菌株同源性。结果患者5次肺炎发作从气管分泌物中分离的10株粪肠球菌株均为利奈唑胺不敏感株(4株为中介耐药株,6株为耐药株),通过PCR和测序发现4株利奈唑胺中介耐药株含有1个拷贝23S r RNA基因V区G2424U突变,而利奈唑胺耐药菌株同时含有G2424U和G2576U双突变。通过PFGE分型检测提示10株粪肠球菌株具有同源性。通过肉汤稀释法鉴定这些菌株均对万古霉素敏感。结论利奈唑胺耐药粪肠球菌株可能长期定植于患者体内,并导致反复感染。
[Abstract]:Objective to study the mutagenesis and colonization characteristics of lenazolidomide resistant Enterococcus faecalis strain in a patient with pulmonary infection. Methods the tracheal secretion of a patient with acute leukemia with recurrent pneumonia (5 episodes in one year) was studied. Ten strains of Enterococcus faecalis were isolated. The MIC value of the strain was determined by E-test. The V region of 23S r RNA gene was amplified by PCR, and the mutation site was analyzed by sequencing. Results 10 strains of Enterococcus faecalis isolated from trachea secretions in 5 episodes of pneumonia were all linazolamide insensitive strains and 4 strains were intermediate resistance strains. By PCR and sequencing, it was found that there was one copy of G2424U mutation in V region of 23S r RNA gene. Both G2424U and G2576U were found in linazolamide resistant strains. PFGE typing showed that 10 strains of Enterococcus faecalis were homologous. These strains were all sensitive to vancomycin by broth dilution method. Conclusion Liniazolamide is sensitive to vancomycin. The drug-resistant Enterococcus faecalis strain may be colonized in the patient for a long time. And lead to repeated infections.
【作者单位】：广东医学院附属深圳市南山区人民医院;
【基金】：深圳市南山区卫生科技计划项目(No.2012028,2012021) 深圳市科技创新-知识创新计划项目(No.45584896-4)
【分类号】：R378.1

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