本文關(guān)鍵詞：肺炎克雷伯分離株耐藥性和毒力基因的相關(guān)性研究　出處：《蘇州大學》2015年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 肺炎克雷伯菌 耐藥性 毒力基因 同源性分析

【摘要】：目的:為了解肺炎克雷伯菌的耐藥性和毒力基因的相關(guān)性,本研究通過對肺炎克雷伯菌臨床分離株的耐藥性及毒力基因進行分析,了解其耐藥譜和毒力基因分布,并分析兩者間的相關(guān)性,為臨床治療提供理論基礎。同時作同源性分析,分析肺炎克雷伯菌間的種系發(fā)生關(guān)系,為菌株的變異、分化、傳播尋找規(guī)律。方法:通過收集119株肺炎克雷伯分離株,對其采用藥敏紙片法分析耐藥性,用PCR技術(shù)檢測耐藥基因SHV、TEM、CTX-M、OXA篩選肺炎克雷伯菌株中的ESBLs菌株,用PCR技術(shù)檢測7種毒力基因rmp A、aer-1、aer-2、mag A、gyrb-2、ybt、wca G,比較ESBLs肺炎克雷伯菌菌株與非ESBLs肺炎克雷伯菌菌株之間毒力基因分布率,分析多重耐藥和毒力基因分布,并分析兩者間的相關(guān)性。用Bio Edit軟件編輯序列,截成有相同數(shù)目位點的片段,用MEGA-4作聚類性和種系發(fā)生樹進行同源性分析。結(jié)果:119株肺炎克雷伯分離株篩選耐藥基因SHV、TEM、CTX-M、OXA檢測出的陽性菌分別為18、20、26、6株,篩選出ESBLs肺炎克雷伯菌32株。119株肺炎克雷伯菌臨床分離株進行多重耐藥譜的分析,耐三種及以上抗菌藥物的多重耐藥率達可達41.17%,耐8-12種抗生素的菌株占得30.25%。119株肺炎克雷伯臨床分離株中不同毒力基因的檢出率之間差異具有統(tǒng)計學意義(P0.05)。119株肺炎克雷伯臨床分離株中含有2種、3種、4種、5種不同毒力基因的菌株占有率相對較高,均在15%以上。對ESBLs與非ESBLs肺炎克雷伯菌菌株之間毒力基因分布率的比較,可明顯看出ESBLs的肺炎克雷伯菌的毒力基因分布率較非ESBLs分布率低很多。對分離株的多重耐藥率和毒力基因數(shù)進行相關(guān)性分析,毒力基因分布數(shù)與耐藥性間的相關(guān)系數(shù)為-0.227(P0.05),呈負相關(guān),具有顯著性差異,表明毒力基因數(shù)與耐藥性間有顯著相關(guān)性;也就是說,毒力基因分布數(shù)越多的菌株,多重耐藥現(xiàn)象出現(xiàn)的幾率就越小。毒力基因分布數(shù)與耐藥基因數(shù)間的相關(guān)系數(shù)為-0.195(P0.05),呈負相關(guān),具有顯著性差異,表明毒力基因數(shù)與耐藥基因數(shù)間有顯著相關(guān)性;也就是說,毒力基因分布數(shù)越多的菌株,耐藥基因分布數(shù)出現(xiàn)的幾率就越小。用MEGA-4作出種系發(fā)生樹如下圖,共有A、B、C、D、E、F六個群,由圖表看出A群為優(yōu)勢群,其次為B群。ESBLs主要在A群,其他群主要以非ESBLs為主。在A群中,非ESBLs中含有的毒力基因相對其他群非ESBLs中含有的毒力基因少,通過對應前面的耐藥與毒力的關(guān)系,可發(fā)現(xiàn)B、C、D、E、F分類群是多毒力基因群,A群是少毒力基因群。各菌群間同源性較高,存在某一克隆群的暴發(fā)。結(jié)論:肺炎克雷伯菌的耐藥性與毒力基因分布存在著相關(guān)性,更傾向于存在負相關(guān),毒力基因分布數(shù)越多的分離株,多重耐藥現(xiàn)象出現(xiàn)的概率就越小,為臨床上對該菌合理的治療及抗生素的合理的使用提供了一些理論依據(jù)。根據(jù)種系發(fā)生樹看出,院內(nèi)感染的肺炎克雷伯菌有某一克隆株的流行和傳播。
[Abstract]:Objective: to correlation between antibiotic resistance and virulence gene solutions of Klebsiella pneumoniae isolated from this study, through the analysis of drug resistance and virulence genes of Klebsiella pneumoniae clinical isolates, the resistance spectrum distribution and virulence genes, and to analyze the correlation between the two, providing a theoretical basis for the clinical treatment of. At the same time, the homology analysis was used to analyze the relationship between Klebsiella pneumoniae (Klebsiella pneumoniae) and the variation, differentiation and propagation of the strains. Methods: by collecting 119 strains of Klebsiella pneumoniae isolates, the Kirby Bauer method analysis of drug resistance, screening ESBLs isolates of Klebsiella pneumoniae strains using PCR technique for the detection of resistance genes SHV, TEM, CTX-M, OXA, PCR detection of 7 virulence genes RMP, A, aer-1, aer-2, MAG, A gyrb-2, YBT, WCA, G, ESBLs between Klebsiella pneumoniae strains and non ESBLs Klebsiella pneumoniae virulence gene distribution, analysis of the distribution of multidrug resistance and virulence genes, and to analyze the correlation between the two. The sequence of Bio Edit software was used to cut into fragments with the same number of loci, and MEGA-4 was used as a clustering and phylogeny tree to analyze the homology. Results: 119 strains of Klebsiella pneumoniae isolates were screened for resistance genes SHV, TEM, CTX-M and OXA. The positive bacteria were 18, 20, 26 and 6, respectively. 32 strains of ESBLs Klebsiella pneumoniae were screened out. 119 strains of Klebsiella pneumoniae clinical isolates were analyzed for multi drug resistance. The multi drug resistance rate of three or more antibiotics was up to 41.17%, and that of 8-12 kinds of antibiotics accounted for 30.25%. The differences in the detection rates of different virulence genes in 119 klebber clinical isolates were statistically significant (P0.05). The 119 strains of klebber clinical isolates containing 2, 3, 4 and 5 different virulence genes were relatively high, all of which were above 15%. Comparing the distribution of virulence genes between ESBLs and non ESBLs Klebsiella pneumoniae, it is obvious that the distribution of virulence genes in ESBLs is much lower than that in non ESBLs. The correlation analysis of the rate of multi drug resistance and virulence gene number of isolates, the distribution of the correlation coefficient between the number of virulence genes and drug resistance of -0.227 (P0.05), negative correlation, with a significant difference, indicate the number of virulence genes and drug resistance are significantly correlated; that is to say, the more the number of virulence gene distribution of strains, probability the emergence of multi drug resistance phenomenon is smaller. The correlation coefficient distribution of virulence genes and resistance genes between the number of the number of -0.195 (P0.05), negative correlation, with a significant difference, indicate the number of virulence genes and resistance gene number was significantly correlated; that is to say, the more the number of virulence gene distribution of strains, the probability distribution of resistance genes in the number of smaller. Using MEGA-4 to make the tree of lineage generation as below, there are six groups of A, B, C, D, E, F, and the chart shows that A group is the dominant group, followed by the B group. ESBLs is mainly in the A group, and the other groups are mainly non - ESBLs. In the A group, the virulence genes in non ESBLs contain less virulence genes than those in other ESBLs groups. By means of the corresponding relationship between resistance and virulence, it can be found that B, C, D, E and F have multiple virulence genes, and A group is a virulence gene group. The homology of each group was high, and there was a outbreak of a clone. Conclusion: the drug resistance and virulence gene distribution of Klebsiella pneumoniae correlation exists, more likely to have negative correlation, the distribution of virulence genes number of isolates, the probability of the emergence of multi drug resistance phenomenon is smaller, and provides some theoretical basis for clinical treatment of the bacteria and antibiotics reasonable reasonable use. According to the phylogeny tree, the infection of Klebsiella pneumoniae has the prevalence and spread of a clone.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R446.5

【相似文獻】

相關(guān)期刊論文 前10條

1 熊海平;湯敏;張宏萍;張偉;趙哲;崔曉燕;;南通市沙門菌毒力基因分布特征的初步研究[J];齊齊哈爾醫(yī)學院學報;2009年19期

2 蔣玖;黃谷良;蔣秉坤;;產(chǎn)單核細胞李斯特菌的毒力基因[J];國外醫(yī)學(微生物學分冊);1992年06期

3 程瓊;龐瑞亮;王若晨;蘇方超;劉軍軍;李郁;;不同源沙門氏菌對小鼠致病力的比較與毒力基因檢測[J];中國人獸共患病學報;2013年05期

4 王中強;陳琛;劉雯靜;柳楠;薛文仲;李婧;蘇文莉;邱少富;王勇;黃留玉;孫巖松;宋宏彬;;北京地區(qū)福氏志賀菌4c亞型毒力基因分析[J];中國公共衛(wèi)生;2011年01期

5 周菁;陳軍;任易;陳麗峰;;利用適配子篩選結(jié)核桿菌H37Rv毒力基因方法探討[J];山東醫(yī)藥;2013年38期

6 付喬芳;邱軍強;胡鯤;楊先樂;安健;;嗜水氣單胞菌毒力基因在傳代過程中的穩(wěn)定性研究[J];生物技術(shù)通報;2011年09期

7 鐘琪,鮑朗;結(jié)核分枝桿菌毒力基因研究進展[J];國外醫(yī)學.流行病學傳染病學分冊;2004年04期

8 楊芳;李秀娟;徐保紅;;副溶血弧菌毒力基因和保守基因研究進展[J];預防醫(yī)學情報雜志;2011年03期

9 李曉晶;趙暉;蘇靜;郭愛玲;張妤;;淡水小龍蝦弧菌分離株毒力基因的篩選與檢測方法的建立[J];食品科學;2011年18期

10 祝進;陸軍;余旭良;白永鳳;;不同來源耐甲氧西林金黃色葡萄球菌毒力基因的研究[J];檢驗醫(yī)學;2012年06期

相關(guān)會議論文 前10條

1 楊小鵑;吳清平;張菊梅;張淑紅;;PCR法檢測0157:H7毒力基因[A];第二屆中國青年學者微生物遺傳學學術(shù)研討會論文集[C];2006年

2 段麗麗;曹三杰;黃小波;文心田;;模擬體內(nèi)應激因素對胸膜肺炎放線桿菌重要毒力基因表達影響的研究[A];中國畜牧獸醫(yī)學會2009學術(shù)年會論文集（下冊）[C];2009年

3 于新芬;潘勁草;孟冬梅;葉榕;張蔚;汪浩秋;謝立;;多重Real-time PCR檢測STEC、EPEC毒力基因的研究[A];應對突發(fā)公共衛(wèi)生事件論壇論文集[C];2005年

4 張瑾;胡大康;牟思華;王貴珍;潘曉;竺佩燕;郟伊范;吳蘇蘇;蔡艷群;朱偉;宋志偉;李向陽;;毒力基因ply有助于肺炎鏈球菌入侵血液系統(tǒng)[A];2012年浙江省檢驗醫(yī)學學術(shù)年會論文集[C];2012年

5 王亞賓;陳麗穎;胡慧;段志剛;崔保安;;腸球菌主要毒力基因多重PCR測定方法的建立[A];中國畜牧獸醫(yī)學會動物傳染病學分會第四次豬病防控學術(shù)研討會論文集[C];2010年

6 李繼昌;佟恒敏;張鐵男;霍貴成;劉寧;;三種致瀉性大腸埃希氏菌毒力基因多重PCR檢測方法的研究[A];中國畜牧獸醫(yī)學會獸醫(yī)藥理毒理學分會第九次學術(shù)討論會論文與摘要集[C];2006年

7 李鵬;劉軍;何永聚;馮書章;;豬鏈球菌2型新毒力基因研究進展[A];中國畜牧獸醫(yī)學會生物制品學分會中國微生物學會獸醫(yī)微生物學專業(yè)委員會2010年學術(shù)年會（第三屆中國獸藥大會學術(shù)論壇）論文集[C];2010年

8 李鵬;劉軍;何永聚;馮書章;;豬鏈球菌2型新毒力基因研究進展[A];中國畜牧獸醫(yī)學會動物傳染病學分會第四次豬病防控學術(shù)研討會論文集[C];2010年

9 胡大康;張瑾;王冬國;劉洋;劉池波;俞蓮花;曲穎;羅新華;楊錦紅;余堅;李向陽;;SP毒力基因psaA和cpsA在SP入侵血液系統(tǒng)中的作用研究[A];2012年浙江省檢驗醫(yī)學學術(shù)年會論文集[C];2012年

10 程瓊;龐瑞亮;王若晨;蘇方超;劉軍軍;魏建忠;孫裴;王桂軍;李郁;;不同來源沙門氏菌對小鼠致病力的比較研究及毒力基因的檢測分析[A];中國畜牧獸醫(yī)學會動物傳染病學分會第十二次人獸共患病學術(shù)研討會暨第六屆第十四次教學專業(yè)委員會論文集[C];2012年

相關(guān)博士學位論文 前2條

1 段麗麗;模擬體內(nèi)應激因素對胸膜肺炎放線桿菌重要毒力基因表達影響的研究[D];四川農(nóng)業(yè)大學;2009年

2 趙李祥;禽病原性大腸桿菌與尿道致病性大腸桿菌毒力基因相關(guān)性與體內(nèi)外表達差異及其ftsk突變株的研究[D];揚州大學;2008年

相關(guān)碩士學位論文 前3條

1 李艷萌;肺炎克雷伯分離株耐藥性和毒力基因的相關(guān)性研究[D];蘇州大學;2015年

2 王利勤;雞源致病性大腸埃希菌耐藥基因及毒力基因檢測研究[D];西北農(nóng)林科技大學;2012年

3 袁進;馬鏈球菌獸疫亞種可能的毒力基因的發(fā)現(xiàn)及分布[D];南京農(nóng)業(yè)大學;2008年

，

本文編號：1345581