下呼吸道感染来源铜绿假单胞菌毒力基因与氟喹诺酮类药物的耐药性研究  

Correlation between virulence genotype and fluoroquinolone drugs resistance in Pseudomonas aeruginosa of lower respiratory tract infection

作　　者：鞠晓红[1] 李瑶[1] 王月华[1] 赵蓬波[2] 

机构地区：[1]吉林医药学院检验学院,吉林132013 [2]吉林省人民医院检验科,长春132000

出　　处：《中国人兽共患病学报》2017年第1期38-42,共5页Chinese Journal of Zoonoses

基　　金：江苏省检验医学重点实验室开放基金项目(No.JSKLM-2014-016)~~

摘　　要：目的检测下呼吸道感染患者分离的铜绿假单胞菌毒力基因exoS、exoU表达及与氟喹诺酮耐药性的相关性。方法收集2015年10月至2016年3月住院患者痰标本中分离的铜绿假单胞菌,以液体稀释法测定药物敏感性;PCR法扩增exoS、exoU基因。结果检出铜绿假单胞菌46株,exoS、exoU基因阳性率分别为86.96%(40/46)和69.57%(32/46),检出率最高的基因型是exoS+/exoU+(60.87%,28/46)。其中36.96%(17/46)为多重耐药菌(MDR)。氟喹诺酮不敏感(FQNS)菌株78.95%(15/19)为MDR,89.47%(17/19)表达exoU基因,明显高于氟喹诺酮敏感(FQ-S)菌株(P<0.05)。与FQ-S菌株相比,FQ-NS菌株耐药严重,对氨曲南和头孢吡肟耐药率高达70%以上,对美罗培南和亚胺培南耐药率高于50%。耐药率较低的药物有多黏菌素B(10.53%,2/19)、阿米卡星(10.53%,2/19)、头孢他啶(15.79%,3/19)和庆大霉素(21.05%,4/19)。结论下呼吸道感染铜绿假单胞菌毒力基因exoS、exoU阳性率较高,以exoS+/exoU+基因型为主。与FQ-S比较,FQ-NS菌株耐药性更为严重,exoU阳性率更高,提示临床应加强毒力基因及耐药性监测。We investigated the correlation between toxin gene exoS,exoU and fluoroquinolone resistance in lower respiratory tract infection with P. aeruginosa so as to provide guidance for reasonable treatment of clinical infections. We collected P. aeruginosa of sputum samples in hospitalized patients from October 2015 to March 2016.The antimicrobial susceptibility was tested by liquid dilution method.The exoS and exoU genes were detected by PCR technique. Results showed that forty-six P. aeruginosa strains were identified from sputum. The exoS and exoU gene positive rate were 86.96%（40/46） and 69.57%（32/46） respectively, and the highest proportion of genotype was exoS＋/exoU＋（60.87%,28/46）. Among them, 36.96% （17/46） were multiple drug-resistant bacteria（MDR）. Fluoroquinolone non-sensitive （FQ-NS） strain were 78.95% （15/19） for MDR and 89.47%（17/19） exoU gene were positive, which was significantly higher than the fluoroquinolone sensitive strains （FQ-S）. Compared with the FQ-S strain, FQ-NS strains were serious drug resistance. The drug resistant rate of cefepime and aztreonam were more than 70%, and then meropenem and imipenem were more than 50%. The drugs of lower resistance rate in FQ-NS strain had polymyxin B（10.53%,2/19）, amikacin（10.53%,2/19）, ceftazidime（15.79%,3/19） and gentamicin （21.05%,4/19）. P. aeruginosa of lower respiratory infection carried toxin genes exoS and exoU were higher, the main genetpy was exoS＋/exoU＋.FQ-NS strains were higher drug resistance rate and a higher proportion of exoU＋ strains than FQ-S strains. We should strengthen virulence genes test and drug resistance monitoring in clinical practice.

关 键 词：铜绿假单胞菌 exoS基因 exoU基因 耐药性 氟喹诺酮耐药 

分 类 号：R378[医药卫生—病原生物学]