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目的研究慢性重型肝炎患者痰泛耐药木糖氧化产碱菌木糖氧化亚种(AXXxx)39种耐药基因。方法应用API鉴定条/PSE5.0药敏条和NMIC/ID-109鉴定/药敏板鉴定和细菌药敏试验,用PCR法检测分离于慢性重型肝炎患者合格痰标本1株泛耐药AXXxx临床分离株16S rRNA、29种β-内酰胺酶基因(bla)、6种氨基糖苷类修饰酶基因(AMEs)、1种消毒剂/磺胺耐药基因(qacE△1-sul1)、3种整合子基因(intⅠ1、2、3)等39种耐药基因,经测序和同源性分析证实并分析其分布情况。结果该菌经16S rRNA测序和同源性分析,证实为AXXxx;经测序和同源性分析证实7种耐药基因阳性〔两种bla基因(blaTEM-116、blaCARB-8)、3种AMEs基因aac(6′)-Ⅱ、aac(3)-Ⅱ、ant(3″)-Ⅰ、qacE△1-sul1和Ⅰ类整合子基因(intⅠ1)〕;其他27种bla基因、3种AMEs基因〔aac(6′)-Ⅰb、aac(3)-Ⅰ、ant(2″)-Ⅰ〕和2种整合子基因(intⅠ2、intⅠ3)均为阴性。结论该株泛耐菌耐药机制为多重机制,主要与7种耐药相关基因〔blaTEM-116、blaCARB-8、aac(6′)-Ⅱ、aac(3)-Ⅱ、ant(3″)-Ⅰ、qacE△1-sul1和Ⅰ类整合子〕有关。
Objective To study the resistance genes of Thyroxypylulose xylose xylostella xylosoxidase (AXXxx) in patients with chronic severe hepatitis. Methods API identification bar / PSE 5.0 drug sensitive strips and NMIC / ID-109 identification / sensitive plate identification and bacterial susceptibility testing were performed. One pan-resistant AXXxx clinical isolates from eligible sputum specimens of patients with chronic severe hepatitis were detected by PCR. 16S rRNA isolates, 29 kinds of β-lactamase genes (bla), 6 kinds of aminoglycoside modified enzyme genes (AMEs), 1 kinds of disinfectants / sulfa resistance gene (qacE △ 1-sul1), 3 kinds of integron Genes (intⅠ1,2,3) 39 kinds of resistance genes, confirmed by sequencing and homology analysis and analysis of its distribution. Results The strain was confirmed to be AXXxx by 16S rRNA sequencing and homology analysis. Seven kinds of resistance genes (blaTEM-116, blaCARB-8), three AMEs genes were confirmed by sequencing and homology analysis aac (3) -I, qacE △ 1-sul1 and Ⅰ integron gene (intⅠ1)]; 27 other bla genes, 3 AMEs [ AAC (6 ’) - Ib, aac (3) - I, ant (2 ") - I] and two integron genes (intI2, intI3) were all negative. Conclusion The mechanism of multidrug resistance is multifactorial and mainly related to seven kinds of drug resistance related genes (blaTEM-116, blaCARB-8, aac (6 ’) - Ⅱ, aac (3) -Ⅰ, qacE △ 1-sul1 and class Ⅰ integron].