本文選題：銅綠假單胞菌 + 整合子　； 參考：《中華醫(yī)院感染學雜志》2016年10期

【摘要】：目的了解醫(yī)院耐碳青霉烯類銅綠假單胞菌中整合子的分布及可變區(qū)中基因盒的類型與細菌耐藥性的關系,為控制醫(yī)院感染提供依據(jù)。方法采用聚合酶鏈反應(PCR)擴增和瓊脂糖凝膠電泳的方法對寧波市醫(yī)療中心李惠利醫(yī)院2012-2014年臨床分離的336株耐碳青霉烯銅綠假單胞菌第1、2類整合子進行篩查,并對整合子陽性菌株的可變區(qū)序列進行測序分析;采用WHONET5.6和SPSS18.0軟件對數(shù)據(jù)進行統(tǒng)計分析。結果 336株臨床菌株中第1類整合子陽性菌株共有42株,陽性率為12.5%;沒有篩選到第2類整合子陽性菌株;42株整合子陽性菌株中,23株可變區(qū)基因盒為aadA6△-orfd,10株可變區(qū)基因盒為aadA6△-ISPa21-aadA6△-orfd,為氨基糖苷類抗菌藥物的耐藥基因,其余9株可變區(qū)未整合基因盒;整合基因盒aadA6△-orfd菌株組阿米卡星、慶大霉素、妥布霉素的耐藥率均明顯高于未整合基因盒菌株組(P0.05);而整合基因盒aadA6△-ISPa21-aadA6△-orfd菌株組阿米卡星、慶大霉素、妥布霉素的耐藥率介于上述兩組之間;42株整合子陽性菌株對阿米卡星、哌拉西林/他唑巴坦、慶大霉素、頭孢吡肟、頭孢他啶、妥布霉素和左氧氟沙星的耐藥率分別為57.1%、73.8%、85.7%、80.9%、95.2%、83.3%和88.1%,均顯著高于整合子陰性菌株(P0.01)。結論耐碳青霉烯類銅綠假單胞菌整合子的攜帶率相對較低,可變區(qū)所攜帶的耐藥基因主要為氨基糖苷類抗菌藥物的耐藥基因,基因盒與菌株的耐藥性呈高度相關,整合子可能還存在著其他機制參與耐藥表型的產(chǎn)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.
【作者單位】： 寧波市醫(yī)療中心李惠利醫(yī)院檢驗科;浙江省人民醫(yī)院檢驗科;
【基金】：國家自然科學基金資助項目(81101291) 浙江省自然科學基金資助項目(Y2110743)
【分類號】：R440

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