弗劳地枸橼酸杆菌的临床分布及其耐药性分析  

Analysis of the clinical distribution and drug resistance of C. freundii

作　　者：朱玉 张龙 魏取好 Zhu Yu;Zhang Long;Wei Quhao(Fengxian hospital affiliated to Anhui University of Science and Technology;Chest hospital affiliated to Shanghai Jiaotong University;Clinical laboratory,Shanghai Fengxian hospital)

机构地区：[1]安徽理工大学附属奉贤医院,上海市奉贤区201400 [2]上海市交通大学附属胸科医院 [3]上海市奉贤医院检验科

出　　处：《齐齐哈尔医学院学报》2022年第12期1109-1113,共5页Journal of Qiqihar Medical University

基　　金：国家自然科学基金(81572034);浙江省自然科学基金项目(LY15H190006);奉贤区(社会类)科技发展基金(20151001)。

摘　　要：目的 了解临床中C.freundii的分布和耐药情况,从而为现阶段少见菌种抗菌药物的使用提供针对性的方案。方法 收集97株2016—2021年非重复C.freundii,运用聚合酶链反应(PCR)筛查第1、2、3类整合酶基因(intI1、intI2、intI3),对intI+的C.freundii采用长片段PCR扩增整合子可变区,通过测序确定可变区基因盒种类。结果 97株C.freundii中,21株第1类整合酶阳性,2株第2类整合酶阳性。扩出的可变区中,有8株是dfrA12-aadA2,其中aac(6’)-II-ereA2-aac3-arr-ereA2和aac(6’)-II-ereA2-tnpA-aac3-arr-ereA2携带的基因盒种类最多。结论 C.freundii菌株整合子携带率低于其他肠杆菌科细菌,其可变区耐药基因盒种类多样,该菌目前临床耐药之所以如此严峻,是与其携带的可变区启动子(Pc)密切相关。碳青霉烯类抗生素(CRE)仍然是对多重耐药菌株具有活性的抗生素,但应限制其使用以避免出现耐药性,而第三代头孢类抗生素依然可作为治疗由C.freundii所引起的感染首选药物。Objective To understand the distribution and drug resistance of C. freundii in clinic, so as to provide a targeted scheme for the use of antibiotics against rare strains at this stage. Methods 97 strains of C. freundii were collected from 2016 to 2021. Polymerase chain reaction(PCR) was used to screen integrase genes(intI1, intI2, intI3). The integrator subvariable region of positive integron strains were amplified by long-fragment PCR, and the type of gene cassettes in the variable region was determined by sequencing.Results Among 97 strains of C. freudii, 21 strains were intI1, 2 strains were intI2, Among the successfully amplified variable regions, 8 strains were dfrA12-aadA2,which aac(6’)-II-ereA2-aac3-arr-ereA2 and aac(6’)-II-ereA2-tnpA-aac3-arr-ereA2 carried the most kinds of gene cassettes.Conclusions The integron carrying rate of C. freundii strains is lower than that of other Enterobacteriaceae bacteria, and its variable region drug resistance gene cassettes are diverse. The severe current clinical drug resistance of the bacteria is closely related to variable region promoter(Pc) it carried. Carbapenem antibiotics(CRE) remain active against multi-resistant strains, but their use should be restricted to avoid the emergence of resistance, while third-generation cephalosporins remain the preferred treatment for infections caused by C. freundii.

关 键 词：弗劳地枸橼酸杆菌 耐药性 整合子 启动子 

分 类 号：R378[医药卫生—病原生物学]