本文選題：Ⅰ類整合子　切入點(diǎn)：基因盒　出處：《中華醫(yī)院感染學(xué)雜志》2014年01期 　論文類型：期刊論文

【摘要】：目的了解社區(qū)感染尿液分離大腸埃希菌中Ⅰ類整合子的分布,并分析其與細(xì)菌耐藥性的關(guān)系。方法選取114株臨床非重復(fù)分離自醫(yī)院門診患者尿液標(biāo)本中的大腸埃希菌,經(jīng)全自動(dòng)細(xì)菌分析系統(tǒng)鑒定并檢測(cè)其對(duì)臨床常用抗菌藥物的耐藥性,聚合酶鏈反應(yīng)(PCR)檢測(cè)Ⅰ類整合酶基因,對(duì)Ⅰ類整合酶陽性菌株用PCR擴(kuò)增并測(cè)序分析可變區(qū)基因盒種類。結(jié)果 114株臨床非重復(fù)分離自尿液大腸埃希菌中有50株檢測(cè)到Ⅰ類整合酶基因;共檢測(cè)出兩種不同長(zhǎng)度的可變區(qū)片段:1 700bp片段(30株)為dfrA17-aadA5,2 100bp片段(5株)為dfrA12-orfF-aadA2,有兩株大腸埃希菌同時(shí)擴(kuò)增出1 700bp和2 100bp的可變區(qū)片段,有17株Ⅰ類整合酶基因陽性大腸埃希菌未擴(kuò)增出可變區(qū);114株大腸埃希菌對(duì)氨芐西林、磺胺甲VA唑/甲氧芐啶和左氧氟沙星的耐藥率較高,50.0%,對(duì)頭孢替坦、亞胺培南、厄他培南、哌拉西林/他唑巴坦、呋喃妥因、阿米卡星耐藥率較低,5.0%;Ⅰ類整合子陽性菌株對(duì)氨芐西林、慶大霉素、妥布霉素和磺胺甲VA唑/甲氧芐啶的耐藥率高于Ⅰ類整合子陰性菌株。結(jié)論與醫(yī)院感染相比,社區(qū)感染尿液中分離的大腸埃希菌受抗菌藥物的選擇壓力相對(duì)較小,其對(duì)常用抗菌藥物的耐藥率、Ⅰ類整合子攜帶率均較低,同時(shí)Ⅰ類整合子中攜帶的基因盒種類也較單一。
[Abstract]:Objective to investigate the distribution of class I integron in isolated Escherichia coli from community infected urine, and to analyze its relationship with bacterial resistance. Methods 114 strains of Escherichia coli were isolated from the urine samples of outpatients in hospital. The drug resistance to antimicrobial agents was identified by automatic bacterial analysis system, and the class I integrase gene was detected by polymerase chain reaction (PCR). Class I integrase positive strains were amplified by PCR and sequenced to analyze the type of variable region gene cassette. Results 50 of 114 clinical isolates of Escherichia coli were found to have class I integrase genes. Two kinds of variable region fragments of different length (30 strains of variable region: 1 700 BP) were identified as dfrA17-aadA5 (2100bp) and 5 strains of DfrA12-orfF-aadA2 were detected. Two strains of Escherichia coli amplified 1700bp and 2100bp variable region fragments at the same time. There were 17 strains of class I integrase gene positive Escherichia coli. 114 strains of Escherichia coli were resistant to ampicillin, sulfamethazol / trimethoprim and levofloxacin, and were resistant to ceftitan, imipenem and ertapenem. The drug resistance rate of piperacillin / tazobactam, furantoin, amikacin was lower than that of ampicillin, gentamycin. The resistance rate of tobramycin and sulfamethazol / trimethoprim was higher than that of class 鈪，

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