肾移植术后感染致病菌的整合子分类及耐药分析  

Bacteria,integron genes classification and drug-resistance correlation analysis of infection after renal transplantation

作　　者：肖增璜[1] 石磊[2] 刘菊珍[1] 黎永玲[1] 

机构地区：[1]暨南大学附属第一医院临床检验中心,广东广州510630 [2]华南理工大学轻工与食品学院,广东广州510640

出　　处：《暨南大学学报（自然科学与医学版）》2006年第6期842-847,共6页Journal of Jinan University(Natural Science & Medicine Edition)

摘　　要：目的:探讨肾移植患者病原菌的整合子基因分类与耐药的相关性,以期控制和预防院内感染,合理使用抗生素。方法:收集我院19例肾移植患者的19株细菌培养结果和药敏试验的资料,用多重PCR方法进行病原菌整合子的基因检测,并用K-B法与M IC法对其进行药敏分析。结果:①19株致病菌在体外药敏实验中都对抗生素产生严重的多重耐药。②产整合酶基因的菌株共12株,占63%;其中革兰阳性球菌3株,占25%;革兰阴性杆菌9株,占75%;其中2株为耐甲氧西林凝固酶阴性葡萄球菌(MRSCON),4株为产超广谱β-内酰胺酶(ESBL)的大肠杆菌,1株为产ESBL的肺炎克雷伯菌,其余为肠球菌1株、肠杆菌3株和洋葱伯克霍尔德菌1株。③产整合酶均为Ⅰ类整合酶,其中检测出耐药基因盒为1 009 bp的5株,1 664 bp 1株。结论:肾移植患者的病原菌都存在严重的多重耐药性并与整合酶基因有密切相关。对肾移植患者病原菌进行整合酶基因与药敏分析是控制和预防病区交叉感染、合理使用抗生素治疗多重耐药细菌,降低病死率的关键因素。Aim： To explore the classification of the integrase genes and the correlation of muhidrug - resistance that gain from the patients＇ pathogen after renal transplantation in order to control and to prevent cross infection in hospital, to apply antibiotics reasonably. Methods： Nineteen outcomes of the bacterial cultivation and the antibiotics sensitivity test datum from 19 patients transplanted in our hospital was collected. M - PCR was to test bacterial integrase genes, and K -B and MIC to analyze the result of the antibiotics sensitivity was used. Results： （ 1 ） All of the 19 pathogen displayed serious multidrug resistance in vitro. （2）In 19 pathogen, there were 12 integrase genes pathogen （63%） among them, 3 strains were Gram - positive Cocci（25% ）, 9 strains were Gram - negative bacilli （75%）.They could be identified 2 strains of MRSA, 4 strains of ESBL E. coli, 1 strain of ESBL peumonicae, 3 strains of Enterfacter, 1 strain of Burkholderia. （3） Integrase genes were all class Ⅰ which included 5 gene kits of 1 009 bp, 1 gene kits of 1 664 bp. Conclusions： The pathogen from the renal patients transplanted had serious multidrug -resistance problem and close relation to integron genes. So it is very important to analyze pathogen integron genes and antibiotics sensitivity test which will be the key factors to control and prevent cross infection in hospital, apply antibiotics to combat multidrug- resistance bacteria reasonably and reduce the rate of death.

关 键 词：肾移植 致病菌 整合子 耐药 

分 类 号：R699.1[医药卫生—泌尿科学]