CAJ | 학술논문

目的：探讨替加环素对多重耐药鲍曼不动杆菌adeB基因表达水平的影响及临床意义。方法选取临床分离的60株多重耐药鲍曼不动杆菌（ MDR－AB），从中筛选出对环丙沙星（ CIP）外排泵编码基因呈阳性的实验菌株15株，用琼脂二倍稀释法检测替加环素作用前后对15株实验菌株的最小抑菌浓度（ MIC），对替加环素作用前后MIC变化相对较大的菌株基因进行测序并对比分析。结果替加环素对MDR－AB的MIC最低为2 mg? mL－1；质量浓度为0，0．62 mg? mL－1替加环素同质量浓度为1．25，2．5 mg? mL－1环丙沙星对MDR－AB的MIC值差异有统计学意义（ P＜0．05）。替加环素作用后，adeB基因片段有15个碱基突变，5处氨基酸发生替换，还有4个突变氨基酸未发生替换。替加环素作用前后adeB基因表达水平分别为（2．51±0．72），（0．87±0．21），差异有统计学意义（P＜0．05）。结论替加环素可抑制MDR－AB外排泵adeB基因表达，降低adeB表达水平，环丙沙星联合替加环素治疗MDR－AB可能提高临床疗效。
목적：탐토체가배소대다중내약포만불동간균adeB기인표체수평적영향급림상의의。방법선취림상분리적60주다중내약포만불동간균（ MDR－AB），종중사선출대배병사성（ CIP）외배빙편마기인정양성적실험균주15주，용경지이배희석법검측체가배소작용전후대15주실험균주적최소억균농도（ MIC），대체가배소작용전후MIC변화상대교대적균주기인진행측서병대비분석。결과체가배소대MDR－AB적MIC최저위2 mg? mL－1；질량농도위0，0．62 mg? mL－1체가배소동질량농도위1．25，2．5 mg? mL－1배병사성대MDR－AB적MIC치차이유통계학의의（ P＜0．05）。체가배소작용후，adeB기인편단유15개감기돌변，5처안기산발생체환，환유4개돌변안기산미발생체환。체가배소작용전후adeB기인표체수평분별위（2．51±0．72），（0．87±0．21），차이유통계학의의（P＜0．05）。결론체가배소가억제MDR－AB외배빙adeB기인표체，강저adeB표체수평，배병사성연합체가배소치료MDR－AB가능제고림상료효。
Objective To investigate the effect of tigecycline on multi-drug resistant Acinetobacter baumannii ( MDR -AB ) adeB gene expre-ssion and its clinical significance.Methods A total of 60 clinical iso-lates of multidrug-resistant Acinetobacter baumannii were selected, from which 15 experimental strains with positive result to ciprofloxacin ( CIP) efflux pump encoded gene were screened.The minimum inhibitory con-centration ( MIC) before and after given tigecycline was determined using agar dilution assay, the gene of the strains with large change of MIC value was sequenced and compared.Results The lowest MIC of tigecy-cline to MDR-AB was 2 mg? mL-1 .The MDR-AB′s MIC of tigecy-cline at concentration of 0 , 0.62 mg? mL-1 and ciprofloxacin at 1.25 , 2.5 mg? mL-1 were significantly different ( P<0.05).After tigecycline treatment, adeB gene segment had 15 bases mutation, 5 amino acids are replaced and 4 mutant amino acid had no substitution.The adeB gene expression levels before and after the treatment of tigecyclin were (2.51 ±0.72) and (0.87 ±0.21), statistically significant (P<0.05). Conclusion Tigecycline inhibits MDR -AB efflux pump adeB gene expression, lowers adeB expression levels. Other agents with its combination for the treatment of MDR-AB might improve the clinical efficacy.