摘要
目的了解肠道门诊分离的副溶血弧菌的抗生素耐药性和毒力基因的携带情况。方法收集分离自2014～2016年首都医科大学附属北京友谊医院肠道门诊腹泻患者粪便的副溶血弧菌,分析其流行病学特征,采用Kirby-Bauer纸片法检测其对16种抗生素的耐药性,采用荧光PCR检测耐热直接溶血素基因(tdh)和耐热相关溶血素基因(trh)的携带情况。结果从临床标本中分离出副溶血弧菌122株,阳性检出率为4.5%。毒力基因检测显示,44.3%菌株tdh单一阳性,4.9%菌株trh单一阳性,11.5%菌株tdh和trh均阳性,39.3%菌株未检出tdh和trh。药敏试验结果显示,副溶血弧菌对氨苄西林、链霉素和磺胺异口恶唑的耐药率高,分别为70.5%、59.8%和60.7%,对头孢吡肟、卡那霉素和环丙沙星敏感度下降,头孢吡肟从83.3%下降到55.2%,卡那霉素从44.4%下降到12.0%,环丙沙星从66.7%下降到29.9%,对萘啶酸、氯霉素、强力霉素、复方新诺明等均敏感。34.4%的菌株为多重耐药菌,以对链霉素、磺胺异口恶唑、氨苄西林耐药最为常见。结论肠道门诊分离的副溶血弧菌tdh+trh+和tdh-trh-的菌株比率增加,对抗生素的敏感性下降,应加强副溶血弧菌的病原学监测,指导临床合理用药。
Objective To investigate the antibiotic resistance and virulence gene of Vibrio parahaemolyticus isolated from the enteric outpatient clinic. Methods The clinical isolates of Vibrio parahaemolyticus were isolated from the enteric outpatient clinic of Beijing Friendship Hospital,Capital Medical University from 2014 to 2016. The resistance of Vibrio parahaemolyticus to 16 antimicrobial agents was conducted by Kirby-Bauer method. Real-time PCR was used to detect the virulence genes tdh and trh. Results One hundred and twenty-two Vibrio parahaemolyticus strains were isolated from clinical samples,with the positive rate of 4. 5%. The virulence gene detection indicated that 44. 3% of the strains only carried the tdh gene,4. 9% of the strains only carried the trh gene,11. 5% strains carried tdh and trh gene both,and 39. 3% strains had neither of these two genes. Susceptibility test indicated that these isolates were highly resistance to ampicillin,streptomycin and sulfamethoxazole,which were 70. 5%,59. 8% and 60. 7%,respectively. The susceptibility to cefepime,kanamycin and ciprofloxacin decreased,from 83. 3% to55. 2%,from 44. 4% to 12. 0%,from 66. 7% to 29. 9%,respectively. Most isolates were susceptible to nalidixic acid,chloramphenicol,doxycycline,cotrimoxazole,etc. 34. 4% of the strains were multi-drug resistant with the predominant multi-drug resistance of streptomycin,sulfamethoxazole and ampicillin. Conclusion The clinical isolates of Vibrio parahaemolyticus in this study showed a higher positive rate of both tdh ＋ trh＋ and tdh-trh-strains and decreased susceptibility to antibiotics. More etiological surveillance to Vibrio parahaemolyticus should be conducted for guiding the clinical rational use of drug.
作者
南征
周妍妍
孙悦
陈美玲
逄波
苏建荣
NAN Zheng;ZHOU Yan-yan;SUN Yue(Clinical Laboratory Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2018年第13期1452-1455,共4页
Journal of Clinical and Experimental Medicine
基金
首都卫生发展科研专项项目(编号:2016-4-1101)
北京市自然科学基金(编号:7164249)
关键词
副溶血弧菌
毒力基因
耐药性
Vibrio parahaemolyticus
Virulence gene
Antibiotic resistance
