口腔定植菌与医院获得性肺炎病原菌同源性研究

发布时间：2018-08-04 18:40

【摘要】：目的从基因水平探讨长期住院的老年患者口腔内需氧致病定植细菌与医院获得性肺炎(HAP)病原菌的同源性。方法选择2012年1-12月老年住院患者62例,入组第1天采集患者咽拭子、龈上菌斑标本,收集HAP患者痰标本确定HAP病原菌;采用重复序列聚合酶链反应技术(rep-PCR)对口腔定植菌及HAP病原菌行同源性研究。结果需氧致病菌定植率咽部为56.45%,龈上菌斑为54.39%,其中革兰阴性杆菌占66.26%,革兰阳性球菌占33.74%,分离最多的细菌依次为铜绿假单胞菌、金黄色葡萄球菌、鲍氏不动杆菌;62例患者中49例住院期间发生HAP,发病率为79.03%,28例患者送检标本确定35株HAP病原菌;rep-PCR显示35株HAP病原菌中26株与口腔内定植菌具有100%同源性。结论长期住院的老年患者口腔内需氧致病菌定植率较高,尤其革兰阴性杆菌,分离最多的依次为铜绿假单胞菌、金黄色葡萄球菌、鲍氏不动杆菌;HAP病原菌与口腔定植菌具有较高同源性,口腔定植菌是HAP病原菌重要的贮存库。
[Abstract]:Objective to investigate the homology of (HAP) pathogens in the oral cavity of elderly patients with hospital-acquired pneumonia (HAP) at the gene level. Methods Sixty-two elderly inpatients from January to December 2012 were selected. Pharynx swabs and supragingival plaque samples were collected on the first day. Sputum specimens of HAP patients were collected to determine the pathogenic bacteria of HAP. Repeat sequence polymerase chain reaction (rep-PCR) was used to study the homology of oral colonization bacteria and HAP pathogens. Results the colonization rate of aerobic bacteria was 56.45 in pharynx and 54.39 in supragingival plaque. Among them, Gram-negative bacilli accounted for 66.26, Gram-positive cocci 33.74. the most isolated bacteria were Pseudomonas aeruginosa and Staphylococcus aureus. Among 62 patients with Acinetobacter baumannii, 49 cases developed HAP during hospitalization. The incidence rate was 79.03 and 28 patients were examined. 35 strains of HAP pathogens were confirmed by rep-PCR. 26 of 35 strains of HAP pathogens had 100% homology with oral colonization bacteria. Conclusion the colonization rate of aerobic bacteria in the oral cavity of the elderly patients with long-term hospitalization was higher, especially Gram-negative bacilli. The most isolated bacteria were Pseudomonas aeruginosa and Staphylococcus aureus. Acinetobacter baumannii has high homology with oral colonization bacteria, which is an important store of HAP pathogens.
【作者单位】：首都医科大学附属北京友谊医院医疗保健中心;首都医科大学附属北京友谊医院临床检验中心;
【基金】：北京市卫生局青年科学研究基金资助项目(QN2009-005) 北京友谊医院科研启动基金项目(2011-27)
【分类号】：R563.1

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