摘要
目的探讨幽门螺杆菌(Hp)耐药情况及其与外排泵基因hefA、hefB、hefC表达的改变。方法选择浙江中医药大学附属第一医院消化科2016年3月-2018年6月收治的Hp培养阳性患者118例作为研究对象,对其药物敏感性分布特点进行调查,提取耐药菌株总RNA,逆转录为cDNA后,采用灰度法对hefA、hefB和hefC基因相对表达水平进行检测。结果 118株临床分离的Hp菌株以耐甲硝唑(88.98%)、耐左氧氟沙星(53.39%)、耐克拉霉素(32.20%)和耐阿莫西林(16.95%)占比较高,均超过10%,呋喃唑酮无耐药菌株检出。共有8株Hp对6种检测抗菌药物均敏感,双重耐药中甲硝唑+左氧氟沙星36例(30.51%);甲硝唑+克拉霉素18例(15.25%);甲硝唑+阿莫西林6例(5.08%);克拉霉素+左氧氟沙星6例(5.08%),三重耐药中甲硝唑+克拉霉素+左氧氟沙星7例(5.93%);hefA、hefB、hefC基因在二重或多药耐药中的相对表达高于单一耐药及全敏感菌株,在单一耐药菌株中相对表达高于全敏感菌株,差异均具有统计学意义(P<0.05);hefA、hefB、hefC三基因相对表达具有相关性,成正相关关系。结论医院Hp耐药形势不断变化,其耐药发生与外排泵基因hefA、hefB、hefC协同上调存在联系,有望作为药物开发靶点,值得进一步研究。
OBJECTIVE To explore the drug resistance of Helicobacter pylori and observe its association with the changes of expression of efflux pump genes hefA,hefB and hefC.METHODS A total of 118 patients who were tested positive for H.pylori and treated in Department of Gastroenterology of the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from Mar 2016 to Jun 2018 were recruited as the study subjects,the characteristics of distribution of drug susceptibility were investigated,the total RNA of drug-resistant strains was extracted and reversed as cDNA,and the relative expression levels of hefA,hefB and hefC genes were detected by using gray scale method.RESULTS Among 118 clinical isolates of H.pylori,88.98%were metronidazole-resistant,53.39%were levofloxacin-resistant,32.20%were clarithromycin-resistant,and 16.95%were amoxicillin-resistant;all exceeding 10%;no furazolidone-resistant strain was detected.Totally 8 strains of H.pylori were susceptible to 6 types of tested antibiotics.Among the patients who were dual-resistant,36 cases(30.51%)were resistant to metronidazole plus levofloxacin,18 cases(15.25%)were resistant to metronidazole plus clarithromycin,6 cases(5.08%)were resistant to metronidazole plus amoxicillin,and 6 cases(5.08%)were resistant to clarithromycin plus levofloxacin.7(5.93%)patients were resistant to metronidazole plus clarithromycin plus levofloxacin.The relative expression of hefA,hefB and hefC genes was significantly higher in the dual or multidrug-resistant strains than in the single and fully-sensitive strains,the relative expression was significantly higher in the single resistant strains than in the fully-sensitive strains(P<0.05).The relative expression of the hefA,hefB and hefC genes was correlated and show a positive correlation.CONCLUSION The situation of drug resistance of the H.pylori is constantly changing.The occurrence of drug resistance is related to the coordinated upregulation of efflux pump genes hefA,hefB,and hefC.It is expected to serve as a target f
作者
赵晶
戴金峰
黄宣
范一宏
乔雪慧
ZHAO Jing;DAI Jin-feng;HUANG Xuan;FAN Yi-hong;QIAO Xue-hui(The First Affiliated Hospital,Hangzhou,Zhejiang 310006,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第21期3233-3237,共5页
Chinese Journal of Nosocomiology
基金
浙江省科技计划基金资助项目(2016C37033)。
关键词
消化内科
幽门螺杆菌
耐药
外排泵
Department of gastroenterology
Helicobacter pylori
Drug resistance
Efflux pump
