鼻咽癌患者鼻咽部菌群分布及耐药性分析  

Investigation on the bacteria distribution of nasopharyngeal site in patients with nasopharyngeal carcinoma

作　　者：胡伟群[1,2] 陈秀芬 黄金樵[1] 茅林蔚[1] 潘志勇[1] 蒋远伟[1] HU Wei-qun;CHEN Xiu-fen;HUANG Jin-qiao;MAO Lin-wei;PAN Zhi-yong;JIANG Yongwei(Affiliated Hospital of Putian College,Putian 351100,Fujian,China;Fujian Medical University)

机构地区：[1]莆田学院附属医院,福建莆田351100 [2]福建医科大学

出　　处：《中国病原生物学杂志》2022年第2期233-235,239,共4页Journal of Pathogen Biology

基　　金：莆田市科技计划项目(No.2019S3F008)。

摘　　要：目的探究鼻咽癌患者鼻咽部菌群分布,对于鼻咽癌患者临床治疗进程具有积极推进作用。方法收集鼻咽部分泌物样本,采用全自动微生物鉴定仪鉴定菌株,采用琼脂稀释法分析表皮葡萄球菌和草绿色链球菌的耐药期刊。PCR扩增、基因测序分析耐药基因变异情况。结果2014-2019年鼻咽癌患者鼻咽部分离菌株112株,各年分离菌株数分别为8、13、11、16、18和46株,分别占7.14%、11.61%、9.82%、14.29%、16.07%和41.07%;其中表皮葡萄球菌39株,草绿色链球菌17株,为优势菌种。表皮葡萄球菌对头孢拉定、罗氏芬、氧哌嗪、西力欣、复达欣、环丙沙星的耐药率分别为5.13%、10.26%、17.95%、20.51%、23.08%和33.33%;草绿色链球菌的耐药率分别为5.88%、5.88%、17.65%、17.65%、23.53%和35.29%。检表皮葡萄球菌和草绿色链球菌环丙沙星耐药菌株中gyrA基因变异率为100%。表皮葡萄球菌中gyrA基因变异位点包括107位碱基(C→G)、251位碱基(C→T)、336位碱基(C缺失),变异率分别为53.85%(7/13)、38.46%(5/13)、7.69%(1/13);草绿色链球菌中,gyrA基因变异位点包括243(C→G)、260(G→T)变异率分别为66.67%(4/6)、33.33%(2/6)。结论鼻咽癌患者鼻咽部菌群中以表皮葡萄球菌和草绿色链球菌为优势菌种。临床治疗中应优先选用头孢拉定,但仍应合理使用。表皮葡萄球菌和草绿色链球菌对环丙沙星的耐药性来自于gyrA基因变异,应减少该类药物使用。Objective Bacteria distribution of nasopharyngeal site in patients with nasopharyngeal carcinoma were investigated,which plays a positive role in promoting the clinical treatment of patients with nasopharyngeal carcinoma.Methods Samples of nasopharyngeal secretions were collected and the distribution of bacteria was analyzed by automatic microbiological identification instrument.Agar dilution method was used to analyze the drug resistance of Staphylococcus epidermidis and Streptococcus viridans.Mutation of drug resistance genes was analyzed by PCR amplification and gene sequencing.Results From 2014to 2019,112strains were isolated from nasopharyngeal carcinoma patients.The number of strains isolated in each year were 8,13,11,16,18and 46,accounting for 7.14%,11.61%,9.82%,14.29%,16.07%and 41.07%respectively.Among them,39strains of S.epidermidis and 17strains of S.viridans were the dominant strains.The drug resistance rates of S.epidermidis to cefradine,roche,piperazine,cilixin,fudachin and ciprofloxacin were 5.13%,10.26%,17.95%,20.51%,23.08%and 33.33%,respectively.The drug resistance rates of S.viridans were 5.88%,5.88%,17.65%,17.65%,23.53%and 35.29%,respectively.The mutation rate of gyrA gene in ciprofloxacin resistant strains of Staphylococcus epidermidis and Streptococcus viridis was 100%.In S.epidermidis,the gyrA gene mutation sites included 107bases(C→G),251bases(C→T),and 336bases(C deletion),with the mutation rates of 53.85%,38.46%,and 7.69%,respectively.In S.viridans,the gyrA gene mutation sites,including 243(C→G)and 260(G→T),the mutation rate were 66.67%and 33.33%,respectively.Conclusion S.epidermidis and S.viridans were dominant bacteria in the nasopharyngeal flora of patients with nasopharyngeal cancer.Cefradine should be chosen as the first choice in clinical treatment,but it should still be used reasonably.Resistance to ciprofloxacin in S.epidermidis and S.viridans due to a gyrA gene mutation and the use of ciprofloxacin should be reduced.

关 键 词：鼻咽癌 菌群分布 耐药性 GYRA基因 

分 类 号：R378[医药卫生—病原生物学]