北京市某院难辨梭菌临床分离株耐药性及毒素基因携带情况分析  

Analysis on drug resistance and toxin gene carrying status of Clostridium difficile clinical isolates in a hospital of Beijing

作　　者：邵冬华[1] 宋燕[1] 梁国威[1] SHAO Donghua;SONG Yan;LIANG Guowei(Department of Clinical Laboratory,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院检验科,北京100049

出　　处：《检验医学》2020年第9期864-867,共4页Laboratory Medicine

基　　金：首都卫生发展科研专项青年课题(首发2014-4-6081)。

摘　　要：目的了解航天中心医院难辨梭菌临床分离株的耐药性及毒素基因携带情况。方法收集不明原因腹泻患者的粪便样本335例,采用TaqMan-MGB探针实时荧光定量聚合酶链反应(PCR)进行菌属鉴定及毒素基因检测。对tpi基因阳性样本进行厌氧培养、分离及药物敏感性试验。回顾性分析分离出A^+B^+菌株和A^-B^+菌株患者的临床资料。结果335例粪便样本中,56例(16.7%)检出难辨梭菌tpi基因,其中10株(17.9%)A^-B^+菌株、46株(82.1%)A^+B^+菌株。检出菌株对阿莫西林、甲硝唑、克林霉素、万古霉素、莫西沙星、氨苄西林-舒巴坦及美罗培南的耐药率分别为7.1%、10.7%、75.0%、0、57.1%、5.4%、8.9%。有29株(51.8%)菌对克林霉素、莫西沙星双重耐药。分离出2种菌的患者病史、临床用药史、常规实验室检测指标差异均无统计学意义(P>0.05)。结论航天中心医院难辨梭菌临床分离株以多重耐药模式多见,A+B+菌株和A-B+菌株感染患者临床特征无差异。Objective To understand the drug resistance and toxin gene carrying status of Clostridium difficile clinical isolates in Aerospace Center Hospital.Methods The stool specimens of clinical unexplained diarrhea patients were detected by TaqMan-MGB probe real-time fluorescence quantitative polymerase chain reaction(PCR)to identify genus gene and toxin gene.Anaerobic culture,isolation and drug susceptibility test were conducted for the positive specimens of tpi gene.The clinical records were analyzed retrospectively,in order to compare the difference between A^+B^+isolates and A^-B^+isolates.Results The tpi gene of 56 specimens was positive in 335 stool specimens,the positive rate was 16.7%,in which 10(17.9%)isolates were A^-B^+isolates,and 46(82.1%)isolates were A^+B^+isolates.The drug resistance rates to amoxicillin,metronidazole,clindamycin,vancomycin,moxifloxacin,ampicillin-sulbactam and meropenem were 7.1%,10.7%,75.0%,0,57.1%,5.4%and 8.9%,respectively.There were 29(51.8%)isolates with drug resistance to both clindamycin and moxifloxacin.There was no statistical significance in patient history,clinical drug history and laboratory data(P>0.05).Conclusions The multiple drug resistance of Clostridium difficile in Aerospace Center Hospital is common.The clinical characteristics are not different between A+B+isolates and A-B+isolates.

关 键 词：难辨梭菌 药物敏感性 毒素基因 

分 类 号：R378.8[医药卫生—病原生物学]