急性腹泻患者的副溶血弧菌毒力及耐药特征分析  

Analysis of Virulence and Drug Resistance of Vibrio Parahaemolyticus in patients with Acute Diarrhea

作　　者：佟世胜 TONG Shisheng(Dashiqiao Third People’s Hospital,Dashiqiao 115104,China)

机构地区：[1]辽宁省大石桥市第三人民医院,辽宁大石桥115104

出　　处：《中国医学创新》2020年第33期165-168,共4页Medical Innovation of China

摘　　要：目的:分析68例急性腹泻患者的副溶血弧菌毒力基因携带情况及抗生素耐药特征。方法:选择2019年1-10月本院就诊的急性腹泻患者68例,收集患者粪便中的副溶血弧菌,采用荧光单重聚合酶链反应(polymerase chain reaction,PCR)检测技术检测其毒力基因tdh、trh和T3SS1、T3SS2,并采用纸片扩散法检测分离的菌株对17种常用抗菌药物的敏感性。结果:68株副溶血弧菌tlh全部阳性,其中有67株毒力基因tdh阳性,tdh携带率为98.53%,2株trh阳性,65株tdh(+)trh(-),2株tdh(+)trh(+),1株tdh(-)trh(-);68株副溶血弧菌均表达了T3SS1基因,65株tdh(+)trh(-)的菌株中有64株表达了T3SS2α基因,2株tdh(+)trh(+)的菌株中有1株表达了T3SS2β基因,其余菌株中未发现。副溶血弧菌对碳氢霉烯类、三代头孢和四环素类抗菌药物敏感性较高,所有菌株对氯霉素、强力霉素、复方新诺明和碳氢霉烯类抗菌药物(亚胺培南、美罗培南)敏感;90%以上的菌株对头孢曲松、阿奇霉素和庆大霉素敏感;对氨苄西林耐药率最高为86.8%,磺胺异噁唑耐药率次之为67.6%。结论:确定致病菌为副溶血弧菌后,临床选择抗生素应以美罗培南或亚胺培南等碳氢霉烯类为首选,其次考虑应用头孢曲松为代表的头孢类药物。Objective:To analyze the virulence gene carrying capacity and antibiotic resistance characteristics of vibrio parahaemolyticus in 68 patients with acute diarrhea.Method:A total of 68 patients with acute diarrhea admitted to our hospital from January 2019 to October 2019 were selected,vibrio parahaemolyticus was collected from the feces of the patients,the virulence genes TDH,TRH,T3SS1 and T3SS2 were detected by fluorescence PCR,and the sensitivity of the isolated strains to 17 commonly used antimicrobial agents was detected by paper diffusion method.Result:All 68 strains of vibrio parahaemolyticus were positive for tlh,among which 67 strains were positive for tdh,tdh carrying rate was 98.53%,2 strains were trh positive,65 strains were tdh (+) trh (-),2 strains were tdh (+) trh (+),1 strains of tdh (-) trh (-).All 68 strains of Vibrio parahaemolyticus expressed the T3SS1 gene,64 strains in the 65 strains of tdh (+) trh (-) expressed the T3SS2α gene,1 strains in the 2 strains of tdh (+) trh (+) expressed the T3SS2β gene was not found in other strains.Vibrio parahaemolyticus was highly sensitive to carbopenems,third-generation cephalosporin and tetracycline antibiotics,all strains were sensitive to Chloramphenicol,Doxycycline,Cotrimoxazole and Carbopenems (Imipenem,Meropenem),more than 90% strains were sensitive to Ceftriaxone,Azithromycin and Gentamicin,the highest resistance rate to Ampicillin was 86.8%,followed by Sulfisoxazole resistance rate was 67.6%.Conclusion:After determining that the pathogenic bacteria is vibrio parahaemolyticus,the clinical selection of antibiotics should be based on carbopenems such as Meropenem or Imipenem,followed by the use of cephalosporins represented by Ceftriaxone.

关 键 词：副溶血弧菌 腹泻 毒力基因 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R57[医药卫生—临床医学]