铜绿假单胞菌临床分离株毒力基因分子流行病学研究  

Molecular epidemiology of virulence genes in clinical isolates of Pseudomonas aeruginosa

作　　者：朱健铭 翁幸鐾[2] 姜如金 吴晋兰[4] 凌莉萍[1] ZHU Jian-ming;WENG Xing-bei;JIANG Ru-jin;WU Jin-Ian;LING Li-ping(Department of Medical Laboratory,Yuhang Hospital of Traditional Chinese Medicine,Hangzhou,Zhejiang 311106,China)

机构地区：[1]杭州市余杭区中医院检验科,浙江杭州311106 [2]宁波市第一医院检验科,浙江宁波315010 [3]杭州市余杭区第一人民医院检验科,浙江杭州311100 [4]杭州市余杭区第五人民医院中医内科,浙江杭州311100

出　　处：《中国卫生检验杂志》2021年第19期2315-2320,共6页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生科技计划项目(2019KY552);杭州市科委医疗卫生科研项目(2018HZ001);杭州市余杭区医疗卫生重大科研项目(2O18YHOO1)。

摘　　要：目的 了解铜绿假单胞菌临床分离株毒力基因分子流行病学特征。方法 收集2018年3月—2020年6月浙江省杭州与宁波2个地区6所医院住院患者首次发现感染时临床分离的113株耐药铜绿假单胞菌,其中来自杭州地区74株,来自宁波地区39株;所有菌株采用琼脂稀释法对13种抗菌药物进行敏感性试验,多黏菌素B用肉汤稀释法;采用PCR及序列分析的方法分析11种毒力基因,阳性基因测序后作BLAST比对。结果 113株耐药铜绿假单胞菌中,多重耐药(MDR)菌占83. 19%,广泛耐药(XDR)菌占11. 50%,所有菌株对多黏菌素B敏感。共检出8种毒力基因,每株菌均检出4种~7种毒力基因,其中plc H、apr A和alg D检出率均为100. 00%,exo Y检出101株(89. 38%),exo S检出95株(84. 07%),pys检出48株(42. 48%),exo U检出40株(35. 40%),oaclR检出11株(9. 73%)。结论 本研究耐药铜绿假单胞菌菌株以携带plc H、apr A、alg D 3种毒力基因为流行特征,这可能是患者均出现铜绿假单胞菌感染症状和体征的重要原因。Objective To investigate molecular epidemiology of vindence genes in Pseudomonas aeruginosa(P.aeruginosa).Methods From March 2018 to June 2020,113 strains of drug resistant P.aeruginosa were collected from inpatients in 6 hospitals in Hangzhou and Ningbo.Among them,74 strains were from Hangzhou and 39 strains were from Ningbo.The sensitivity of P.aeruginosa to 13 antimicrobial agents was performed by agar dilution method,and broth dilution was performed to polymyxin B.Eleven virulence genes were analyzed by PCR and sequence analysis.Positive genes were sequenced and compared with BLAST.Results Among 113 drug-resistant P.aeruginosa,83.19%were MDR and 11.50%were XDR.All strains conferred sensitive to polymyxin B.8 virulence genes were positive,and every stain harbored 4-7 virulence genes.The positive rates of plcH,aprA,algD were 100.00%,exoY was detected in 101 strains(89.38%),exoS was detected in 95 strains(84.07%),pys was detected in 48 strains(42.48%),exoU was detected in 40 strains(35.40%),oaclR was detected in 11 strains(9.73%).Conclusion Three virulence genes:plcH,aprA,algD,were the epidemiological characteristics of drug-resistant P.aeruginosa,which may play a key role to result in symptoms and signs of P.aeruginosa infection.

关 键 词：铜绿假单胞菌 耐药 毒力基因 分子流行病学 

分 类 号：R446.5[医药卫生—诊断学]