泛耐药铜绿假单胞菌耐药与毒素基因的样本聚类分析  

Sample cluster analysis of exotoxin genes and drug resistance genes in pandrug-resistant Pseudomonas aeruginosa

作　　者：王珊珊[1] 江洁曙[1] 方晶晶[1] 颜碧清[1] 厉旭光[1] 殷颖杰[1] 陶静[1] 

机构地区：[1]宁波大学医学院附属医院ICU,浙江宁波315000

出　　处：《中华医院感染学杂志》2014年第6期1325-1327,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查一组泛耐药铜绿假单胞菌的耐药基因与毒力基因存在状况和菌株间的亲缘关系。方法收集2010年1-12月分离自医院住院患者痰标本的泛耐药铜绿假单胞菌共25株,用聚合酶链反应(PCR)及序列分析的方法分析23种β-内酰胺酶基因、膜孔蛋白oprD2基因、6种氨基糖苷类修饰酶基因、2种16SrRNA甲基化酶基因,2种可移动遗传元件遗传标记基因,再对检测结果作样本聚类分析。结果 25株泛耐药铜绿假单胞菌共检出7种耐药基因:包括2种β-内酰胺类耐药相关基因blaGES、blaVIM基因,阳性率分别为80.0%、20.0%,2种氨基糖苷类耐药相关基因aac(6′)-Ⅰb和ant(2″)-Ⅰ基因,阳性率分别为100.0%和20.0%,2种可移动遗传元件的遗传标记intⅠ、tnp513基因和外毒素toxA基因,阳性率分别为100.0%、20.0%和100.0%,部分菌株存在oprD2缺失阳性率20.0%;样本聚类将菌株分为大小两个簇群,均为克隆传播暴发。结论尽管泛耐药铜绿假单胞菌菌株药敏表型相同,但样本聚类分析将菌株分为两个簇群,研究耐药基因检测并同步解析了25株泛耐药铜绿假单胞菌对头孢类、氨基糖苷类药物耐药的遗传学背景。OBJECTIVE To investigate the prevalence of drug resistance genes and exotoxin genes in pandrugresistant Pseudomonas aeruginosa and observe the phylogenetic relationship between the strains. METHODS From Jan 2010 to Dec 2010, totally 25 strains of pandru-resistant P. aeruginosa were isolated from the sputum specimens obtained from the hospitalized patients, then the drug resistance genes were analyzed by polymerase-chain-reaetion （PCR） and sequence analysis method, including 23 kinds of beta-laetamase genes, oprD2, 6 kinds of aminoglycoside modifying enzyme genes, 2 kinds of 16SrRNA methylase genes, and 2 kinds of genetic markers of mobile genetic elements; the sample cluster analysis was performed. RESULTS Totally 7 kinds of drug resistance genes have been detected in the 25 strains of pandrug-resistant P. aeruginosa, including 2 kinds of beta-lactam resistance-associated genes （blaGES, blaVIM） , 2 kinds of aminoglycoside resistance-associated genes （aac（6t）- I b, ant（2＂）- I , 2 kinds of genetic markers of mobile genetic elements （int I 1, tnp513）, and exotoxin gene toxA, and the positive rates were 8p. 0%, 20.0%, 100.0%, 20.0M, 100.0%, 20.0%, and 100.0M, respectivelyl moreover, oprD2 loss in part of strains with the positive rate of 20.0%. Furthermore, this group of strains were divided into 2 clusters by sample cluster analysis, which showed clonal spread and outbreak. CONCLUSION Although the drug susceptibility phenotypes of this group of strains are the same, the group of the strains are divided into two clusters through the sample cluster analysis; the detection of the drug resistance genes has simultaneously interpreted the genetic background of the drug resistance of the 25 strains of pandrug-resistant P. aeruginosa to cephalosporins and aminoglycosides.

关 键 词：铜绿假单胞菌 8-内酰胺类 氨基糖苷类 可移动遗传元件 外毒素 样本聚类分析 泛耐药 

分 类 号：R378.991[医药卫生—病原生物学]