慢性非变应性鼻炎患者鼻前庭定植革兰阴性菌携带的整合子研究  

Study on integron carried by gram-negative bacteria from nasal vestibule of patients with chronic nonallergic rhinitis

作　　者：王科[1] 常会敏[1] 张海鹏 乔峰 WANG Ke;CHANG Huimin;ZHANG Haipeng;QIAO Feng(Otorhinolaryngology Head and Neck Surgery Department,the First Affiliated Hospital of Xi'an Medical University,Xi'an 710077,China)

机构地区：[1]西安医学院第一附属医院耳鼻咽喉头颈外科,陕西西安710077

出　　处：《临床医学研究与实践》2020年第25期8-11,共4页Clinical Research and Practice

摘　　要：目的探讨慢性非变应性鼻炎患者鼻前庭分离的革兰阴性菌的耐药性及整合子携带状况。方法纳入2017年1月至2018年12月就诊于某三甲医院门诊的357例慢性非变应性鼻炎患者为研究对象,分离和鉴定患者鼻前庭拭子上的革兰阴性菌。应用纸片扩散法(K-B法)对革兰阴性菌进行药物敏感试验。采用PCR法扩增三类整合酶基因及其可变区序列,对PCR产物进行测序并分析。结果357例慢性非变应性鼻炎患者中,117例分离出119株革兰阴性菌。22株菌扩增出第一类整合酶基因,并未扩增出第二类整合酶基因和第三类整合酶基因。14株菌经PCR法扩增出整合子可变区片段,测序结果显示,其携带的耐药基因盒为氨基糖苷类药物耐药基因aadA1、aadA2、aadA5、aadA16、aadB、aacA7,甲氧苄啶耐药基因dfrA12、dfrA15、dfrA17、dfrA27,喹诺酮类耐药基因aac(6')-Ib-cr,氯霉素耐药基因catB3,利福平耐药基因arr-3。结论慢性非变应性鼻炎患者鼻前庭定植有携带整合子的耐药革兰阴性菌,对该类患者进行适当的干预将会有效地控制耐药革兰阴性菌在院内或社区的潜在传播。Objective To investigate the drug resistance and integron carrying status of gram-negative bacteria isolated from nasal vestibule of patients with chronic nonallergic rhinitis.Methods A total of 357 patients with chronic nonallergic rhinitis admitted in outpatient department of a top three hospital from January 2017 to December 2018 were included as the study objects,and gram-negative bacteria on nasal vestibular swabs were isolated and identified.The disk diffusion test(K-B method)was used to detect the drug sensitivity of gram-negative bacteria.The PCR method was performed to amplify the three integrase genes andvariable regions,and the PCR products were sequenced and analyzed.Results Of the 357 patients with chronic nonallergic rhinitis,119 strains of gram-negative bacteria were isolated in 117 cases.The classⅠintegrase gene was amplified in 22 strains,but the classⅡintegrase gene and the classⅢintegrase gene were not amplified.The integron variable region fragment was amplified by PCR method in 14 strains.The results of sequencing showed that the resistance gene cassette were aminoglycoside drug-resistant genes aadA1,aadA2,aadA5,aadA16,aadB,aacA7,trimethoprim-resistant genes dfrA12,dfrA15,dfrA17,dfrA27,quinolone resistant gene aac(6')-Ib-cr,chloramphenicol resistant gene catB3,and rifampicin resistant gene arr-3.Conclusion The nasal vestibule of patients with chronic nonallergic rhinitis is colonized with drug-resistant gram-negative bacteria carrying integron.Appropriate intervention for these patients will effectively control the potential transmission of drug-resistant gram-negative bacteria in hospital or community.

关 键 词：慢性非变应性鼻炎 革兰阴性菌 药物敏感试验 整合子 耐药基因盒 

分 类 号：R446.5[医药卫生—诊断学] R765.41[医药卫生—临床医学]