福氏志贺菌耐药性与整合子耐药基因盒特征分析  

Analysis of the drug resistance and the integron resistance gene cassette＇s characteristics of Shigella flexneri

作　　者：马全萍[1] 刘雅毳 刘靓雯[3] 姚明晓 苑广盈[3] 

机构地区：[1]济南市第四人民医院检验科,250031 [2]济南市市中区疾病预防控制中心检验科 [3]山东大学附属济南市传染病医院检验科 [4]山东省疾病预防控制中心病毒所

出　　处：《中华儿科杂志》2015年第10期765-770,共6页Chinese Journal of Pediatrics

摘　　要：目的 探讨福氏志贺菌多重耐药性与其整合子携带的耐药基因盒的关系.方法 收集2009年5月至2012年4月济南市部分医院就诊的6个月～14岁腹泻患儿粪便分离的福氏志贺菌79株,Kirby-Bauer法（K-B纸片扩散法）测定福氏志贺菌的耐药性,PCR扩增1、2、3类整合子酶基因,对阳性菌株可变区进行酶切和序列分析.结果 分离的79株福氏志贺菌对氨苄西林、氯霉素、四环素、链霉素的耐药率均为91％（72/79）,磺胺甲基异嗯唑-甲氧苄啶的耐药率为70％ （55/79）,对头孢噻肟、头孢他啶、环丙沙星和左旋氧氟沙星的耐药率分别为30％（24/79）、23％ （18/79）、33％（26/79）、32％（25/79）,对头孢西丁、头孢哌酮-舒巴坦、亚胺培南100％敏感.常见的耐药模式为氨苄西林-四环素-氯霉素-链霉素,占91％（72/79）.79株福氏志贺菌中,intI1阳性72株、intI2阳性68株,阳性率分别为91％（72/79）、86％（68/79）,intI3均阴性.非典型1类整合子阳性菌株对氨苄西林、链霉素、四环素、氯霉素耐药明显高于非典型1类整合子阴性菌株（x2=35.96,P＜0.01）.测序结果经BLAST比对：1类整合子可变区检出9株dfrV、2株dfrA17-aadA5、70株blaOXA-30-aadA1耐药基因盒,2株可变区未检出耐药基因.2类整合子可变区全部检出dfrA1-sat1-aadA1耐药基因盒.结论 济南地区福氏志贺菌存在的多重耐药与携带的整合子密切相关.Objective To investigate the correlation between Shigella flexneri multi-drug resistance and drug resistance gene cassette of integrons.Method All 79 strains of Shigella flexneri were isolated from the feces of children ranged in age from 6 months to 14 years in some hospitals of Jinan,between May 2009 and April 2012.The resistance was detected by Kirby Bauer agar diffusion method,1,2 and 3 integron gene was amplified by PCR,the variable region of positive strains treated with enzyme digestion and determined by Series Analysis.Result Among 79 Shigella flexneri strains,the resistance rate was 91% （72/79） to ampicillin,chloramphenicol,tetracycline,streptomycin,70% （55/79） to sulfamethoxazole/trimethoprim,30% （24/79）,23% （18/79）,33% （26/79） and 32% （25/79） to cefotaxime,ceftazidime,ciprofloxacin and levofloxacin.All 79 strains were susceptible to cefoxitin,imipenem,cefoperazone/sulbactam.The common drug resistance pattern is ampicillin tetracycline-chloramphenicol-streptomycin,accounted for 91% （72/79）;91% （72/79） strains carried integrons of class 1,86% （68/79） strains carried integrons of class 2,No intI3 was detected.The resistance to ampicillin,streptomycin,tetracycline,chloramphenicol of atypical class 1 integron positive strains was significantly higher than the negative strains（x2 =35.96,P 〈 0.01）.The sequencing results：dfrV was detected in class 1 integron variable regions of 9 strains,dfrA17-aadA5 in 2 strains,blaOXA-30-aadA1 in 70 strains,2 strains were not detected resistance gene cassette,all resistance gene cassettes were dfrA1-sat1-aadA1 in class 2 integron variable regions.Conclusion The mutidrug resistance of Shigella flexneri in Jinan was closely associated with integrons.

关 键 词：志贺菌属 抗药性 整合子类 

分 类 号：R446.5[医药卫生—诊断学]