烧伤创面感染病原菌耐药性及外周血T淋巴细胞亚群和MC1R基因多态性  

Drug resistance of pathogens isolated from patients with burn wound infections,peripheral blood T lymphocyte subsets and MC1R gene polymorphisms

作　　者：张建涛 安亮恩 周辉芳 赵跃 李海鑫 ZHANG Jian-tao;AN Liang-en;ZHOU Hui-fang;ZHAO Yue;LI Hai-xin(Hospital of The First Mobile Corps of The Chinese People's Armed Police Force,Dingzhou,Hebei 073000,China;不详)

机构地区：[1]武警第一机动总队医院外一科,河北定州073000 [2]联勤保障部队第九八〇医院烧伤整形科,河北石家庄050082 [3]联勤保障部队第九八〇医院感染科,河北石家庄050082

出　　处：《中华医院感染学杂志》2024年第21期3316-3320,共5页Chinese Journal of Nosocomiology

基　　金：河北省医学科学研究课题计划基金资助项目(20211094)。

摘　　要：目的探讨烧伤创面感染病原菌耐药性及外周血T淋巴细胞亚群和黑皮质素-1受体(MC1R)基因多态性。方法选取2021年8月-2023年8月联勤保障部队第980医院收治的68例烧伤发生创面感染患者为研究组,随机选取72例同期符合纳入排除标准的烧伤未发生创面感染患者为对照组,统计病原菌分布,进行耐药性分析,比较两组外周血T淋巴细胞亚群水平(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))及MC1R基因多态性分布情况。结果68例烧伤发生创面感染患者共培养出79株病原菌,主要包括铜绿假单胞菌和金黄色葡萄球菌。铜绿假单胞菌对头孢唑林、氨苄西林耐药严重,对环丙沙星敏感;金黄色葡萄球菌对青霉素耐药严重,对替加环素敏感。研究组CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)表达低于对照组(P<0.05),CD_(8)^(+)表达高于对照组(P<0.05)。研究组MC1R基因分型CC、等位基因C高于对照组(P<0.05),等位基因T低于对照组(P<0.05)。两组MC1R基因分型TT、TC比较,无统计学差异。结论烧伤创面感染患者主要病原菌为铜绿假单胞菌和金黄色葡萄球菌,铜绿假单胞菌对头孢唑林、氨苄西林耐药严重,金黄色葡萄球菌对青霉素耐药严重。烧伤患者创面感染与T淋巴细胞亚群水平、MC1R基因多态性有关。OBJECTIVE To explore the drug resistance of pathogens isolated from the patients with burn wound infections,analyze the peripheral blood T lymphocyte subsets and observe the gene polymorphisms of melanocortin-1 receptor(MC1R).METHODS A total of 68 patients with burn wound infections who were treated in NO.980 Hospital of the People′s Liberation Army Joint Logistics Support Force from Aug.2021 to Aug.2023 were assigned as the study group,meanwhile,72 patients who met the inclusion and exclusion criteria but did not have wound infections were chosen as the control group.The distribution of pathogens was statistically analyzed,the drug resistance was observed,and the levels of peripheral blood T lymphocyte subsets(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+)and CD_(4)^(+)/CD_(8)^(+))and MC1R gene polymorphisms were compared between the two groups.RESULTS Totally 79 strains of pathogens were isolated from the 68 patients with burn wound infections,among which Pseudomonas aeruginosa and Staphylococcus aureus were dominant.The P.aeruginosa strains were highly resistant to cefazolin and ampicillin but were sensitive to ciprofloxacin;the S.aureus strains were highly resistant to penicillin but were sensitive to tigecycline.The expression levels of CD_(3)^(+),CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the study group were lower than those of the control group(P<0.05),while the expression level of CD_(8)^(+)of the study group was higher than that of the control group(P<0.05).The frequencies of CC genotype and C allele of MC1R gene of the study group were higher than those of the control group(P<0.05),while the frequency of T allele of the study group was lower than that of the control group(P<0.05).There were no significant differences in the frequencies of TT and TC genotypes of MC1R gene between the two groups.CONCLUSIONS P.aeruginosa and S.aureus are the predominant species of pathogens isolated from the patients with burn wound infections.The P.aeruginosa strains are highly resistant to cefazolin and ampicillin,and the S.aureus strai

关 键 词：烧伤 创面感染 病原菌 耐药性 T淋巴细胞亚群 黑皮质素-1受体 基因多态性 

分 类 号：R644[医药卫生—外科学]