儿科患者感染流感嗜血杆菌耐药基因检测及耐药性分析  

Detection of drug resistance genes and analysis of the drug resistance of Haemophilus influenzae infecting pediatric patients in the Henan region

作　　者：王海磊[1] 马娜 娄春艳[1] 

机构地区：[1]河南大学淮河医院PICU,河南开封475000 [2]开封市儿童医院神经内科

出　　处：《中国病原生物学杂志》2015年第11期1031-1034,共4页Journal of Pathogen Biology

摘　　要：目的研究医院儿科患者感染流感嗜血杆菌的耐药情况并对其耐药基因进行检测,为控制流感嗜血杆菌感染的发生及临床合理选药提供指导。方法收集2014年住院患儿的送检标本,分离流感嗜血杆菌并进行鉴定;采用KB纸片法进行流感嗜血杆菌的药敏试验,测定临床分离株对常用抗生素的耐药性;从临床分离株中提取耐药基因进行PCR扩增,然后将扩增的TEM基因产物进行核苷酸序列测定。结果共分离311株流感嗜血杆菌,对四环素、氨苄西林、氨苄西林/舒巴坦、氨曲南、头孢呋辛、头孢噻肟、头孢他啶、环丙沙星、左氧氟沙星、亚胺培南的耐药率依次为37.94%、33.76%、17.68%、14.79%、13.83%、8.68%、8.68%、7.72%、6.75%和0%。PCR检测110株流感嗜血杆菌临床分离株,72株TEM基因阳性,阳性率为65.45%;24株ROB基因阳性,阳性率为21.82%。其余14株均未检测到耐药基因。TEM基因扩增产物大小为421bp,ROB基因扩增产物大小为334bp。结论流感嗜血杆菌临床分离株仅对亚胺培南敏感,因此应在避免菌株对此药物产生耐药性的基础上及时开发新药。流感嗜血杆菌临床分离株携带的耐药基因仍以TEM为主要类型,控制此基因的位点突变具有重要意义。Objective The drug resistance of Haemophilus influenzae infecting pediatric patients was studied and its drug resistance genes were detected in order to guide the control of infection with H. influenzae and to guide rational drug selection in clinical settings. Methods Samples from pediatric patients were collected in 2014 and H. influenzae was isolated and identified. A drug sensitivity test was performed using the K-B method, and clinical isolates of H. in- fluenzae were tested for their resistance to commonly used drugs. Drug resistance genes were extracted from clinical iso lates and amplified with PCR, and then the products of amplification of the TEM gene were sequenced. Results A total of 311 strains of H. influenzae were isolated. Their resistance to tetracycline was 37.94%, their resistance to ampicillin was 33.76%, their resistance to ampicillin/sulbactam was 17.68%, their resistance to aztreonam was 14.79%, their re- sistance to cefuroxime was 13.83%, their resistance to cefotaxime was 8. 68%, their resistance to ceftazidime was 8. 68%, their resistance to ciprofloxacin was 7. 72%, their resistance to levofloxacin was 6. 75 %, and their resistance to imipenem was 0%. One hundred and ten clinical isolates of H. influenza were detected with PCR. Of those, 72 strains tested positive for the TEM gene （65.45%） and 24 tested positive for the ROB gene （21.82%）. Drug resistance genes were not detected in the remaining 14 strains. Amplification of the TEM gene yielded a product 421 bp in length, and am- plification of the ROB gene yielded a product 334 bp in length. Conclusion Clinical isolates of H. influenzae were only sensitive to imipenem, and thus new drugs should promptly be developed to avoid producing drug-resistant strains. The main type of drug resistance gene found in clinical isolates was the TEM, and controlling point mutations in this gene is crucial.

关 键 词：儿科患者 流感嗜血杆菌感染 耐药基因 耐药性 

分 类 号：R378.41[医药卫生—病原生物学]