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目的了解临床分离阴沟肠杆菌整合子的分布情况,探讨I类整合子与其耐药性关系。方法收集2014年9月-2015年6月本院临床分离的阴沟肠杆菌,用Vitek2-compact全自动微生物分析仪进行细菌鉴定和大部分药敏试验,少部分采用K-B法,PCR法检测I类整合酶、基因盒。用Hinf I对基因盒的PCR产物进行酶切,相同酶切图谱随机挑取1例进行测序。结果Ⅰ类整合子检出率为54.7%(64/117)。整合子阳性菌对头孢曲松、头孢他啶、庆大霉素、阿米卡星、妥布霉素、环丙沙星、左旋氧氟沙星、复方新诺明的耐药率明显高于阴性菌,差异均有统计学意义(P<0.05)。基因盒种类以及菌株数分别为dfrA17-aadA5(26株)、aacA4-cat B8-aadA1(10株)、dfrA15-aadA2(7株)、dfrA12-orf FaadA2(6株)、aad B-aadA2(5株)、dfrA1-aadA5(4株)、cat B8-aadA1(2株)、dfrA15(2株)。结论 I类整合子在介导阴沟肠杆菌多重耐药性方面有重要作用。
Objective To understand the distribution of clinical isolates of Enterobacter cloacae integron and discuss the relationship between class I integron and drug resistance. Methods The clinical isolates of Enterobacter cloacae collected from September 2014 to June 2015 in our hospital were collected and bacteria identification and most susceptibility tests were performed with a Vitek2-compact automatic microbiological analyzer. The KB method and the PCR method were used to detect class I Integrase, gene cassette. The PCR products of the gene cassette were digested with Hinf I, and the same enzyme digestion pattern was randomly selected for sequencing. Results The positive rate of class Ⅰ integrons was 54.7% (64/117). The resistance rates of integron-positive bacteria to ceftriaxone, ceftazidime, gentamicin, amikacin, tobramycin, ciprofloxacin, levofloxacin and cotrimoxazole were significantly higher than those of negative bacteria , The differences were statistically significant (P <0.05). The number of gene cassettes and the number of strains were dfrA17-aadA5 (26 strains), aacA4-cat B8-aadA1 (10 strains), dfrA15-aadA2 (7 strains), dfrA12-orf FaadA2 DfrA1-aadA5 (4 strains), cat B8-aadA1 (2 strains) and dfrA15 (2 strains). Conclusion Class I integrons play an important role in mediating the multi-drug resistance of Enterobacter cloacae.