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作 者:李艳阳[1] 王文英[1] 娄春艳[1] 高杰[1] LI Yan-yang;WANG Wen-ying;LOU Chun-yan;GAO Jie(Huaihe Hospital,Henan University,Henan Kaifeng 47500)
出 处:《中国病原生物学杂志》2018年第7期774-777,共4页Journal of Pathogen Biology
摘 要:目的研究致儿童急性肾小球肾炎A组链球菌(GAS)致病基因及耐药。方法选取本院2014年1月-2017年6月期间收治急性链球菌感染后肾炎患儿为研究对象。采用微量肉汤稀释法测定最小抑菌浓度(MIC)对青霉素、红霉素、氯霉素、环丙沙星、四环素、头孢曲松和万古霉素7种临床常用抗生素进行药敏试验。设计emm基因、SpeB基因、NudA基因和NudB基因,并进行PCR扩增。采用BLAST将产物序列与GenBank中进行同源性比对,并对结果判读。结果本次研究中共成功分离出GAS菌株113株,其中2~6岁71例,6~11岁42例。GAS分离株未对青霉素、环丙沙星和万古霉素产生耐药性。对红霉素、氯霉素、四环素和头孢曲松耐药率分别为99.12%(112株)、90.27%(102株)、84.96%(96株)和2.65%(3株)。对单一抗生素耐药为7株(6.19%),对两种抗生素耐药13株(11.50%),对三种以上抗生素耐药93株(82.30%)。GAS分型:emm2型6株,emm4型10株,emm12型72株,emm25型3株,emm49型6株,emm57型4株,emm61型12株。113株GAS中,56株携带Aph3基因(49.56%),71株携带Aac6-I基因(62.83%),96株携带tetM基因(84.96%),113株携带链球菌外毒素B(100%),NudA和NudB各检出61株,携带率为53.98%。结论随着广谱类抗生素的应用,A组链球菌感染儿童急性肾小球肾炎日益减少,但耐药程度越来越高。Objective To study group AStreptococcus(GAS)causing acute post-streptococcal glomerulonephritis.Methods Subjects were children with acute post-streptococcal glomerulonephritis who were diagnosed and treated at this Hospital from January 2014 to June 2017.Susceptibility to penicillin,erythromycin,chloramphenicol,ciprofloxacin,tetracycline,ceftriaxone,and vancomycin was tested using the broth microdilution method.The Emm gene,SpeB gene,NudA gene,and NudB gene were identified and amplified with PCR.Resulting sequences were compared with those in GenBank using BLAST,and the results were interpreted. Results One hundred and thirteen strains of GAS were isolated.Seventy-one patients were 2-6 years of age and 42 cases were 6-11 years of age.The GAS isolates were not resistant to penicillin,ciprofloxacin,or vancomycin.Of the 113 strains,112(99.1%)were resistant to erythromycin,102(90.3%)were resistant to chloramphenicol,96(85%)were resistant to tetracycline,and 3(2.7%)were resistant to ceftriaxone.Seven strains(6.2%)were resistant to a single antibiotic,13(11.5%)were resistant to two antibiotics,and 93(82.3%)were resistant to three or more antibiotics.According to GAS typing,6 strains were the emm2 type,10 were the emm4 type,72 were the emm12 type,3 were the emm25 type,6 were the emm49 type,4 were the emm57 type,and 12 were the emm61 type.The Aph3 gene was detected in 56 strains(49.6%),the Aac6-I gene was detected in 71(62.8%),the tetM gene was detected in 96(85.0%),the SpeB gene was detected in 113(100%),the NudA gene was detected in 61(53.98%),and the NudB gene was detected in 61(53.98%). Conclusion With the use of broad-spectrum antibiotics,GAS infections in children with acute glomerulonephritis have decreased,but GAS is increasingly resistant to commonly used drugs.The SpeB gene was detected at a high rate,and this gene helps GAS to evade the host's immune system
关 键 词:A组链球菌 急性肾小球肾炎 耐药机制 emm基因 SpeB基因
分 类 号:R378.14[医药卫生—病原生物学]
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