医学临床研究
醫學臨床研究
의학림상연구
JOURNAL OF CLINICAL RESEARCH
2014年
12期
2311-2314,2317
,共5页
沙门菌,鼠伤寒%沙门菌,肠炎%抗药性,细菌%电泳,凝胶,脉冲场
沙門菌,鼠傷寒%沙門菌,腸炎%抗藥性,細菌%電泳,凝膠,脈遲場
사문균,서상한%사문균,장염%항약성,세균%전영,응효,맥충장
Salmonella typhimurium%Salmonella enteritidis%Drug Resistance,Bacterial%Electro-phoresis,Gel,Pulsed-Field
目的研究本地区沙门菌临床分离株的的耐药状况、分子流行病学特征及对头孢菌素类药物的耐药机制。方法采用琼脂稀释法测定临床常用抗菌药物对沙门菌的最低抑菌浓度(MIC)值,使用 PCR 法和DNA测序法检测头孢菌素耐药基因,脉冲场凝胶电泳(PFGE)法对沙门菌进行同源性分析。结果本地区肠炎沙门菌为主要血清型,占59.9%(91/152)。所有被测菌株均对亚胺培南敏感,对萘啶酸的耐药率最高(86.2%),其次是氨苄西林(59.9%)、氯霉素(36.2%)和四环素(34.9%)。46.1%(70/152)的沙门菌对3种及以上抗菌药物耐药,其中鼠伤寒沙门菌的多重耐药率比肠炎沙门菌高(85.2%>31.9%)。对头孢菌素耐药的14株沙门菌进行PCR扩增并测序均为blaCTX-M型,其中7株为blaCTX-M-55,4株为blaCTX-M-14,2株blaCTX-M-3和1株 blaCTX-M-15。91株肠炎沙门菌分成23个PFGE型,27株鼠伤寒沙门菌分成15个 PFGE 型。PFGE 型别存在多个克隆系。结论本地区沙门菌多重耐药现象严重,产 blaCTX-M型超广谱β-内酰胺酶(ESBLs)是沙门菌对头孢菌素耐药的重要机制。本研究中沙门菌的 ESBLs 基因以 blaCTX-M-55型为主。沙门菌 PFGE 型别多样,存在明显的遗传多样性。
目的研究本地區沙門菌臨床分離株的的耐藥狀況、分子流行病學特徵及對頭孢菌素類藥物的耐藥機製。方法採用瓊脂稀釋法測定臨床常用抗菌藥物對沙門菌的最低抑菌濃度(MIC)值,使用 PCR 法和DNA測序法檢測頭孢菌素耐藥基因,脈遲場凝膠電泳(PFGE)法對沙門菌進行同源性分析。結果本地區腸炎沙門菌為主要血清型,佔59.9%(91/152)。所有被測菌株均對亞胺培南敏感,對萘啶痠的耐藥率最高(86.2%),其次是氨芐西林(59.9%)、氯黴素(36.2%)和四環素(34.9%)。46.1%(70/152)的沙門菌對3種及以上抗菌藥物耐藥,其中鼠傷寒沙門菌的多重耐藥率比腸炎沙門菌高(85.2%>31.9%)。對頭孢菌素耐藥的14株沙門菌進行PCR擴增併測序均為blaCTX-M型,其中7株為blaCTX-M-55,4株為blaCTX-M-14,2株blaCTX-M-3和1株 blaCTX-M-15。91株腸炎沙門菌分成23箇PFGE型,27株鼠傷寒沙門菌分成15箇 PFGE 型。PFGE 型彆存在多箇剋隆繫。結論本地區沙門菌多重耐藥現象嚴重,產 blaCTX-M型超廣譜β-內酰胺酶(ESBLs)是沙門菌對頭孢菌素耐藥的重要機製。本研究中沙門菌的 ESBLs 基因以 blaCTX-M-55型為主。沙門菌 PFGE 型彆多樣,存在明顯的遺傳多樣性。
목적연구본지구사문균림상분리주적적내약상황、분자류행병학특정급대두포균소류약물적내약궤제。방법채용경지희석법측정림상상용항균약물대사문균적최저억균농도(MIC)치,사용 PCR 법화DNA측서법검측두포균소내약기인,맥충장응효전영(PFGE)법대사문균진행동원성분석。결과본지구장염사문균위주요혈청형,점59.9%(91/152)。소유피측균주균대아알배남민감,대내정산적내약솔최고(86.2%),기차시안변서림(59.9%)、록매소(36.2%)화사배소(34.9%)。46.1%(70/152)적사문균대3충급이상항균약물내약,기중서상한사문균적다중내약솔비장염사문균고(85.2%>31.9%)。대두포균소내약적14주사문균진행PCR확증병측서균위blaCTX-M형,기중7주위blaCTX-M-55,4주위blaCTX-M-14,2주blaCTX-M-3화1주 blaCTX-M-15。91주장염사문균분성23개PFGE형,27주서상한사문균분성15개 PFGE 형。PFGE 형별존재다개극륭계。결론본지구사문균다중내약현상엄중,산 blaCTX-M형초엄보β-내선알매(ESBLs)시사문균대두포균소내약적중요궤제。본연구중사문균적 ESBLs 기인이 blaCTX-M-55형위주。사문균 PFGE 형별다양,존재명현적유전다양성。
Obj ective]To study the antimicrobial resistance situation,molecular epidemiology and cepha-losporins-resistance mechanism of Salmonella spp .isolated from clinical cases in local region.[Methods]Minimal inhibitory concentrations(MICs)of common antibiotics to Salmonella spp .were measured by agar dilution method.PCR and DNA sequencing method were used to detect cephalosporins-resistance gene.Pulsed field electrophoresis(PFGE)method was performed for determining the homogeneity of Salmonella spp .[Re-sults]Salmonella enteritidis isolates in local region was the main serotype,and accounted for 59.9%(91/152). All the strains were sensitive to imipenem and the resistance to nalidixic acid was the highest(86.2%),fol-lowed by ampicillin(59.9%),chloramphenicol(36.2%)and tetracycline(34.9%).About 46.1%(70/152)i-solates of Salmonella spp .were multiple resistant to 3 and more antimicrobials,and multiple resistance of Salmonella typhimurium isolates was higher than Salmonella enteritidis isolates(85.2% vs.31.9%).Fourteen Salmonella spp .isolates were resistant to cephalosporin and positive for blaCTX-M (7 for blaCTX-M-55 ,4 for blaCTX-M-14 ,2 for blaCTX-M-3 and 1 for blaCTX-M-15 )amplified by PCR.The 91 strains of Salmonella enteritidis were divided into 23 PFGE types and 27 strains of Salmonella typhimurium were divided into 15 PFGE types.PFGE types had multiple clones.[Conclusion]The situation of multiple antimicrobial resistance of Salmonella spp . in local region is serious.Production of CTX-M-type extended-spectrumβ-lactamases(ESBLs)is the prevalent mechanism responsible for the resistance to cephalosporins in Salmonella spp .In our study,ESBLs gene is dominated by blaCTX-M-55 .The PFGE types of Salmonella spp .come from different clones and have significant genetic diversity.
