外膜蛋白A与鲍曼不动杆菌耐药性及炎症反应特征分析  

Analysis of outer membrane protein A and characteristics of resistance and inflammatory response of Acinetobacter baumannii

作　　者：赵丹[1] 李尼克 李雯[1] 胡芳芳 彭春红[1] 张湘燕[1] Zhao Dan;Li Nike;Li Wen;Hu Fangfang;Peng Chunhong;Zhang Xiangyan(The Respiratory and Critical Care Medical deparment of Guizhou Provincial People’s Hospital,Respiratory Diseases Institute of Guizhou;Guizhou Medical University graduate student;The Clinical laboratory of Guizhou Provincial People’s Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院呼吸与危重症医学科、贵州省呼吸疾病研究所,贵州贵阳550002 [2]贵州医科大学研究生院,贵州贵阳550002 [3]贵州省人民医院检验科,贵州贵阳550002

出　　处：《贵州医药》2023年第3期346-349,共4页Guizhou Medical Journal

基　　金：贵州省科技厅基础研究计划一般项目(黔科合基础[2020]1Y291);国家自然科学基金地区科学基金项目(项目批准号81660002)。

摘　　要：目的 回顾性分析鲍曼不动杆菌外膜蛋白A (OmpA)与细菌耐药性及炎症反应指标的特征,为临床鲍曼不动杆菌的防治提供依据。方法 回顾性分析我院2019年1月至2020年12月收治的53例鲍曼不动杆菌感染患者,根据药敏结果分为敏感株组、耐药株组,分析每组中患者临床特点及外周血中白细胞计数(WBC)、中性粒细胞百分比(N%)、降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)的水平,PCR及RT-PCR检测每组鲍曼不动杆菌OmpA DNA及mRNA的表达,探讨两组中以上指标的变化及意义。结果 鲍曼不动杆菌临床药敏以多粘菌素B耐药率最低,为3.2%,其次为替加环素,为15.79%。53例鲍曼不动杆菌均有OmpA基因表达;耐药株组OmpA mRNA、CRP、IL-6水平均显著高于敏感株组(P<0.05);两组WBC、N%、PCT水平比较均无统计学意义(P>0.05)。耐药株组鲍曼不动杆菌OmpA mRNA的相对表达水平与PCT成正相关,r=0.379(P<0.05),与WBC、N%、IL-6、CRP无相关性(P>0.05)。结论 OmpA参与细菌耐药机制的同时,作为主要的毒力因子,促进了细菌的致炎反应。Objective To retrospectively analyze the characteristics of Acinetobacter baumannii outer membrane protein A(OmpA),bacterial resistance and inflammatory response indicators,so as to provide a basis for clinical prevention and treatment of Acinetobacter baumannii.Methods Fifty-three patients with Acinetobacter baumannii infection admitted to Gui Zhou Provincial People’s Hospital from January 2019 to December 2020 were retrospectively analyzed.According to the results of drug sensitivity,these patients were divided into susceptible strain group and resistant strain group.The clinical characteristics of patients in each group and the levels of white blood cell count(WBC),neutrophil percentage(N%),procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)in peripheral blood were analyzed.PCR and RT-PCR were used to detect the expression of OmpA DNA and mRNA of Acinetobacter baumannii in each group,and to explore the changes and significance of the above indexes in the two groups.Results Clinical susceptibility test showed that the resistance rate of Acinetobacter baumannii to polymyxin B was the lowest,3.2%,followed by tigecycline,15.79%.Fifty-three cases of Acinetobacter baumannii showed OmpA gene expression.The levels of OmpA mRNA,CRP and IL-6 in the drug-resistant group were significantly higher than those in the sensitive group(P<0.05).There was no significant difference in WBC,N%and PCT levels between the two groups(P>0.05).The relative expression level of OmpA mRNA was significantly correlated with PCT(r=0.379,P<0.05).There was no correlation with WBC,N%,IL-6 and CRP(P>0.05).Conclusion Acinetobacter baumannii OmpA is involved in the mechanism of bacterial resistance,and as a major virulence factor,it promotes the bacteriostasis of bacteria.

关 键 词：鲍曼不动杆菌 外膜蛋白A 细菌耐药 炎症反应 

分 类 号：R446.5[医药卫生—诊断学]