检验医学 ›› 2024, Vol. 39 ›› Issue (1): 47-52.DOI: 10.3969/j.issn.1673-8640.2024.01.009
王艳艳1, 王俊瑞1, 郑文琪1, 兰海霞2, 郭素芳1()
收稿日期:
2022-10-19
修回日期:
2023-05-16
出版日期:
2024-01-30
发布日期:
2024-03-04
通讯作者:
郭素芳,E-mail:guosf@163.com。
作者简介:
王艳艳,女,1983年生,主管技师,主要从事病原菌耐药及致病机制研究。
基金资助:
WANG Yanyan1, WANG Junrui1, ZHENG Wenqi1, LAN Haixia2, GUO Sufang1()
Received:
2022-10-19
Revised:
2023-05-16
Online:
2024-01-30
Published:
2024-03-04
摘要:
目的 分析拟杆菌属临床分布及其耐药特征,并探讨脆弱拟杆菌肠毒素bft基因分型特征。方法 收集2016年6月—2019年6月内蒙古医科大学附属医院分离自临床样本的拟杆菌属147株,对其进行菌种鉴定和体外药物敏感性试验。采用聚合酶链反应(PCR)检测脆弱拟杆菌肠毒素bft基因。结果 147株拟杆菌属细菌中,脆弱拟杆菌100株(68.0%)、多形拟杆菌25株(17.0%)、卵形拟杆菌9株(6.1%)。体外药物敏感性试验结果显示,拟杆菌属细菌对克林霉素的耐药率最高(78.9%);脆弱拟杆菌对克林霉素的耐药率为85.0%,高于其他拟杆菌(66.0%)。拟杆菌属细菌对亚胺培南和甲硝唑的耐药率分别为13.6%和4.7%,对其他抗菌药物呈不同程度耐药;脆弱拟杆菌对大部分抗菌药物的耐药率均高于其他类型拟杆菌。脆弱拟杆菌bft基因阳性率为38.0%,以bft-1亚型为主要基因型(28.0%),其次为bft-2亚型(10.0%),未检出bft-3亚型。分离自非腹部临床样本的脆弱拟杆菌bft基因阳性率(55.6%)高于分离自腹部临床样本的脆弱拟杆菌(36.3%)。结论 拟杆菌属临床分离株中脆弱拟杆菌分离率最高,其对临床常用抗菌药物均有一定的耐药性。分离自非腹部临床样本的脆弱拟杆菌产肠毒素的菌株流行率更高,应引起临床重视。
中图分类号:
王艳艳, 王俊瑞, 郑文琪, 兰海霞, 郭素芳. 拟杆菌属临床分离株耐药性及脆弱拟杆菌肠毒素bft基因分型特征分析[J]. 检验医学, 2024, 39(1): 47-52.
WANG Yanyan, WANG Junrui, ZHENG Wenqi, LAN Haixia, GUO Sufang. Drug resistance of Bacteroides isolated from clinic and characteristics of Bacteroides fragilis bft genotyping[J]. Laboratory Medicine, 2024, 39(1): 47-52.
基因 | 引物序列(5'~3') | 产物长度/bp |
---|---|---|
bft | F:GGATACATCAGCTGGGTTGTAG | |
R:GCGAACTCGGTTTATGCAGT | 296 | |
bft-1 | F:TCTTTTGAATTATCCGTATGCTC | |
R:CTTGGGATAATAAAATCTTAGGGATG | 196 | |
bft-2 | F:ATTTTTAGCGATTCTATACATGTTCTC | |
R:GGGCATATATTGGGTGCTAGG | 114 | |
bft-3 | F:TGGATCATCCGCATGGTTA | |
R:TTTGGGCATATCTTGGCTCA | 148 |
表1 引物序列
基因 | 引物序列(5'~3') | 产物长度/bp |
---|---|---|
bft | F:GGATACATCAGCTGGGTTGTAG | |
R:GCGAACTCGGTTTATGCAGT | 296 | |
bft-1 | F:TCTTTTGAATTATCCGTATGCTC | |
R:CTTGGGATAATAAAATCTTAGGGATG | 196 | |
bft-2 | F:ATTTTTAGCGATTCTATACATGTTCTC | |
R:GGGCATATATTGGGTGCTAGG | 114 | |
bft-3 | F:TGGATCATCCGCATGGTTA | |
R:TTTGGGCATATCTTGGCTCA | 148 |
样本类型 | 脆弱拟杆菌 | 多形拟杆菌 | 卵形拟杆菌 | 普通拟杆菌 | 其他拟杆菌 | 拟杆菌属 |
---|---|---|---|---|---|---|
腹腔脓液 | 91 | 20 | 9 | 6 | 4 | 130 |
口腔脓液 | 0 | 2 | 0 | 1 | 0 | 3 |
生殖道脓液 | 2 | 1 | 0 | 0 | 0 | 3 |
头部脓液 | 1 | 1 | 0 | 0 | 0 | 2 |
肢端脓液 | 2 | 0 | 0 | 0 | 0 | 2 |
血液 | 4 | 1 | 0 | 1 | 1 | 7 |
合计 | 100 | 25 | 9 | 8 | 5 | 147 |
表2 拟杆菌属细菌样本来源分布 株
样本类型 | 脆弱拟杆菌 | 多形拟杆菌 | 卵形拟杆菌 | 普通拟杆菌 | 其他拟杆菌 | 拟杆菌属 |
---|---|---|---|---|---|---|
腹腔脓液 | 91 | 20 | 9 | 6 | 4 | 130 |
口腔脓液 | 0 | 2 | 0 | 1 | 0 | 3 |
生殖道脓液 | 2 | 1 | 0 | 0 | 0 | 3 |
头部脓液 | 1 | 1 | 0 | 0 | 0 | 2 |
肢端脓液 | 2 | 0 | 0 | 0 | 0 | 2 |
血液 | 4 | 1 | 0 | 1 | 1 | 7 |
合计 | 100 | 25 | 9 | 8 | 5 | 147 |
抗菌药物 | 敏感/[%(株/株)] | 中介/[%(株/株)] | 耐药/[%(株/株)] |
---|---|---|---|
拟杆菌属 | |||
甲硝唑 | 94.6(139/147) | 0.7(1/147) | 4.7(7/147) |
哌拉西林-他唑巴坦 | 93.9(119/147) | 1.4(2/147) | 6.8(10/147) |
头孢西丁 | 85.0(125/147) | 11.6(17/147) | 3.4(5/147) |
哌拉西林 | 82.3(121/147) | 1.4(2/147) | 16.3(24/147) |
亚胺培南 | 79.6(117/147) | 6.8(10/147) | 13.6(20/147) |
氨苄西林-舒巴坦 | 68.7(101/147) | 6.8(10/147) | 24.5(36/147) |
克林霉素 | 19.7(29/147) | 1.4(2/147) | 78.9(116/147) |
抗菌药物 | 敏感/[%(株/株)] | 中介/[%(株/株)] | 耐药/[%(株/株)] |
脆弱拟杆菌 | |||
甲硝唑 | 93.0(93/100) | 1.0(1/100) | 6.0(6/100) |
哌拉西林-他唑巴坦 | 90.0(90/100) | 1.0(1/100) | 9.0(9/100) |
哌拉西林 | 87.0(87/100) | 0(0/100) | 13.0(13/100) |
头孢西丁 | 86.0(84/100) | 13.0(13/100) | 1.0(1/100) |
亚胺培南 | 79.0(79/100) | 5.0(5/100) | 16.0(16/100) |
氨苄西林-舒巴坦 | 66.0(66/100) | 6.0(6/100) | 28.0(28/100) |
克林霉素 | 15.0(15/100) | 0(0/100) | 85.0(85/100) |
其他拟杆菌 | |||
甲硝唑 | 97.9(46/47) | 0(0/47) | 2.1(1/47) |
哌拉西林-他唑巴坦 | 95.7(45/47) | 2.1(1/47) | 2.1(1/47) |
亚胺培南 | 87.2(41/47) | 10.6(5/47) | 2.1(1/47) |
头孢西丁 | 83.0(39/47) | 8.5(4/47) | 8.5(4/47) |
氨苄西林-舒巴坦 | 74.5(35/47) | 8.5(4/47) | 17.0(8/47) |
哌拉西林 | 72.3(34/47) | 4.3(2/47) | 23.4(11/47) |
克林霉素 | 29.8(14/47) | 4.3(2/47) | 66.0(31/47) |
表3 拟杆菌属细菌对抗菌药物的耐药率
抗菌药物 | 敏感/[%(株/株)] | 中介/[%(株/株)] | 耐药/[%(株/株)] |
---|---|---|---|
拟杆菌属 | |||
甲硝唑 | 94.6(139/147) | 0.7(1/147) | 4.7(7/147) |
哌拉西林-他唑巴坦 | 93.9(119/147) | 1.4(2/147) | 6.8(10/147) |
头孢西丁 | 85.0(125/147) | 11.6(17/147) | 3.4(5/147) |
哌拉西林 | 82.3(121/147) | 1.4(2/147) | 16.3(24/147) |
亚胺培南 | 79.6(117/147) | 6.8(10/147) | 13.6(20/147) |
氨苄西林-舒巴坦 | 68.7(101/147) | 6.8(10/147) | 24.5(36/147) |
克林霉素 | 19.7(29/147) | 1.4(2/147) | 78.9(116/147) |
抗菌药物 | 敏感/[%(株/株)] | 中介/[%(株/株)] | 耐药/[%(株/株)] |
脆弱拟杆菌 | |||
甲硝唑 | 93.0(93/100) | 1.0(1/100) | 6.0(6/100) |
哌拉西林-他唑巴坦 | 90.0(90/100) | 1.0(1/100) | 9.0(9/100) |
哌拉西林 | 87.0(87/100) | 0(0/100) | 13.0(13/100) |
头孢西丁 | 86.0(84/100) | 13.0(13/100) | 1.0(1/100) |
亚胺培南 | 79.0(79/100) | 5.0(5/100) | 16.0(16/100) |
氨苄西林-舒巴坦 | 66.0(66/100) | 6.0(6/100) | 28.0(28/100) |
克林霉素 | 15.0(15/100) | 0(0/100) | 85.0(85/100) |
其他拟杆菌 | |||
甲硝唑 | 97.9(46/47) | 0(0/47) | 2.1(1/47) |
哌拉西林-他唑巴坦 | 95.7(45/47) | 2.1(1/47) | 2.1(1/47) |
亚胺培南 | 87.2(41/47) | 10.6(5/47) | 2.1(1/47) |
头孢西丁 | 83.0(39/47) | 8.5(4/47) | 8.5(4/47) |
氨苄西林-舒巴坦 | 74.5(35/47) | 8.5(4/47) | 17.0(8/47) |
哌拉西林 | 72.3(34/47) | 4.3(2/47) | 23.4(11/47) |
克林霉素 | 29.8(14/47) | 4.3(2/47) | 66.0(31/47) |
样本类型 | 分离菌株 | bft阳性 | bft-1阳性 | bft-2阳性 | bft-3阳性 |
---|---|---|---|---|---|
腹部样本 | 91(91.0) | 33(36.3) | 23(30.8) | 10(11.0) | 0(0) |
非腹部样本 | 9(9.0) | 5(55.6) | 5(55.6) | 0(0) | 0(0) |
合计 | 100(100.0) | 38(38.0) | 28(28.0) | 10(10.0) | 0(0) |
表4 100株脆弱拟杆菌bft毒素基因分型结果 株(%)
样本类型 | 分离菌株 | bft阳性 | bft-1阳性 | bft-2阳性 | bft-3阳性 |
---|---|---|---|---|---|
腹部样本 | 91(91.0) | 33(36.3) | 23(30.8) | 10(11.0) | 0(0) |
非腹部样本 | 9(9.0) | 5(55.6) | 5(55.6) | 0(0) | 0(0) |
合计 | 100(100.0) | 38(38.0) | 28(28.0) | 10(10.0) | 0(0) |
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