B族链球菌规律成簇间隔短回文重复序列与基因分型及耐药基因的关系  

Association of clustered regularly interspaced short palindromic repeats with genotyping and drug-resistance genes of group B Streptococcus

作　　者：白宇茜 康文娟[2] 张新华[3] 郭超[2] 徐丽君 孟晋华[2] 张莉[2] Bai Yuxi;Kang Wenjuan;Zhang Xinhua;Guo Chao;Xu Lijun;Meng Jinhua;Zhang Li(Department of Epidemiology,School of Public Health,Shanxi Medical University,Taiyuan 030001,China;Department of Clinical Examination Center Scientific Research,Children's Hospital Affiliated to Shanxi Medical University(Shanxi Maternal and Child Health Care Hospital),Taiyuan 030013,China;Department of Neonatology,Children's Hospital Affiliated to Shanxi Medical University(Shanxi Maternal and Child Health Care Hospital),Taiyuan 030013,China)

机构地区：[1]山西医科大学公共卫生学院流行病学教研室,太原030001 [2]山西医科大学附属儿童医院(山西省妇幼保健院)临检中心科研部,太原030013 [3]山西医科大学附属儿童医院(山西省妇幼保健院)新生儿科,太原030013

出　　处：《中华围产医学杂志》2022年第12期898-903,共6页Chinese Journal of Perinatal Medicine

基　　金：山西省基础研究计划(20210302123360)。

摘　　要：目的:探讨孕晚期孕妇生殖道定植及侵袭性感染患儿的B族链球菌(group B Streptococcus,GBS)规律成簇间隔短回文重复序列(clustered regularly interspaced short palindromic repeats,CRISPR)分布及其与多位点序列分型(multilocus sequence typing,MLST)、耐药基因的关系。方法:回顾性收集2017年1月至2022年1月山西医科大学附属儿童医院(山西省妇幼保健院)收治的孕晚期孕妇定植GBS及GBS侵袭性感染患儿临床分离的84株GBS菌株(包括侵袭性菌株17株、定植菌株67株),检测其CRISPR、MLST、耐药表型及耐药基因。采用χ^(2)检验或Fisher精确概率法进行统计分析,并采用MEGA11构建发育树图。结果:84株中共有10种ST型别,最常见的是ST10(46.4%)。GBS对青霉素敏感,对红霉素和克林霉素的耐药率分别为75.0%和73.8%;17株GBS侵袭性菌株中,ST10型对红霉素、克林霉素以及左氧氟沙星耐药率达100%。62株检出CRISPR1基因,阳性率为73.8%;CRISPR1阳性菌株中ST10占比显著高于CRISPR1阴性菌株[56.5%(35/62)与18.2%(4/22),χ^(2)=9.56,P=0.002];CRISPR1阳性菌株中检出ermB、gyrA、parC比例明显高于阴性菌株[分别为54.8%(34/62)与22.7%(5/22)、67.7%(42/62)与36.4%(8/22)及71.0%(44/62)与36.4%(8/22),χ^(2)值分别为6.73、6.64及8.25,P值均<0.05],而ermA的比例低于阴性菌株[6.5%(4/62)与31.8%(7/22),χ^(2)=7.09,P=0.008]。结论:ST10是孕妇生殖道定植GBS及婴儿侵袭性GBS感染的主要基因型;GBS对青霉素敏感;在CRISPR1阳性菌株中ST10型GBS占优势;CRISPR1与部分耐药基因的传播相关。Objective To investigate the distribution of clustered regularly interspaced short palindromic repeats(CRISPR)in group B Streptococcus(GBS)in the genital tract of women during the third trimester and in infants with invasive infection and its relationship with multilocus sequence typing(MLST)and drug-resistance genes.Methods This study retrospectively collected 84 GBS strains isolated from pregnant women with GBS colonization and infants with invasive GBS infection who were admitted to Children's Hospital Affiliated to Shanxi Medical University from January 2017 to January 2022.CRISPR,MLST,and drug-resistance phenotype and genes were detected and analyzed usingχ^(2) test or Fisher exact probability method.MEGA11 was used to construct a dendrogram.Results There were ten sequence typing in the 84 GBS strains and ST10 was the dominant one(46.4%).GBS was sensitive to penicillin,and its resistance rates to erythromycin(75.0%)and clindamycin(73.8%)were high.Among the 17 invasive GBS strains,ST10 had 100%resistance to erythromycin,clindamycin,and levofloxacin.CRISPR1 gene was amplified in 62 strains(73.8%).CRISPR1-positive strains had a significantly higher proportion of ST10[56.5%(35/62)vs 18.2%(4/22),χ^(2)=9.56,P=0.002]and ermB,gyrA,parC[54.8%(34/62)vs 22.7%(5/22),67.7%(42/62)vs 36.4%(8/22),71.0%(44/62)vs 36.4%(8/22);χ^(2)=6.73,6.64,and 8.25,all P<0.05],and a lower proportion of ermA[6.5%(4/62)vs 31.8%(7/22),χ^(2)=7.09,P=0.008]than CRISPR1-negative strains.Conclusions ST10 is the main GBS genotype among the colonized microbiota the genital tract of pregnant women and in infants with invasive GBS infection,which is also a dominant type in CRISPR1-positive strains.GBS is sensitive to penicillin and CRISPR1 gene is linked to the spread of some drug-resistance genes.

关 键 词：B族链球菌 CRISPR相关蛋白质类 抗药性 细菌 规律成簇间隔短回文重复序列 多位点测序分型 链球菌感染 传染性疾病传播 垂直 妊娠并发症 感染性 

分 类 号：R714.7[医药卫生—妇产科学]