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对从患者中分离出的革兰氏阴性杆菌中的五种广宿主范围质粒的调查。

A survey of five broad-host-range plasmids in gram-negative bacilli isolated from patients.

作者信息

Zhang Guo-qiang, Yao Yi-hui, Yu Xiao-lu, Niu Jian-jun

机构信息

Center for Clinical Laboratory, Xiamen University Affiliated Zhongshan Hospital, Xiamen, China.

Department of Hospital Epidemiology and Infection Control, Xiamen University Affiliated Zhongshan Hospital, Xiamen, China.

出版信息

Plasmid. 2014 Jul;74:9-14. doi: 10.1016/j.plasmid.2014.05.002. Epub 2014 May 24.

Abstract

OBJECTIVES

To learn the prevalence of the primary classical broad-host-range (BHR) IncA/C, IncN, IncP, IncQ, and IncW plasmids in dominant gram-negative bacilli from inpatients in a teaching hospital in southern China.

METHODS

A multiplex polymerase chain reaction based on the replicons of BHR IncA/C, IncN, IncP, IncQ, and IncW plasmids was developed and used to determine these BHR plasmids. The difference in prevalence rates among the different species from three specimens was evaluated by a binary logistic regression model and the differences between multidrug-resistant organisms (MDRO) and non-MDRO were assessed using a chi-square test.

RESULTS

The average positive detection percentages of the replicons were 4.3%, 3.7%, 3.0%, 2.6%, and 1.9%, respectively, for IncN, IncP, IncQ, IncW, and IncA/C in descending order. The distribution of all five BHR plasmids did not differ significantly between specimens collected from wounds and urine, although both were significantly higher than those of sputum. The prevalence rates of all five BHR plasmids in MDROs were significantly higher than those in non-MDRO for Enterobacteriaceae; however, no significant difference was seen in non-fermenting gram-negative bacilli (NFGNB).

CONCLUSIONS

BHR IncA/C, IncN, IncP, IncQ, and IncW plasmids, which occur more often in bacilli from wound and urine specimens than those of sputum, are widespread in Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter cloacae, Pseudomonas aeruginosa, and Acinetobacter baumannii strains isolated from inpatients. The prevalence rates in MDRO are higher than those in non-MDRO for Enterobacteriaceae but not significantly different for NFGNB.

摘要

目的

了解中国南方一家教学医院住院患者中主要的经典广宿主范围(BHR)IncA/C、IncN、IncP、IncQ和IncW质粒在优势革兰氏阴性杆菌中的流行情况。

方法

基于BHR IncA/C、IncN、IncP、IncQ和IncW质粒的复制子开发了一种多重聚合酶链反应,并用于检测这些BHR质粒。通过二元逻辑回归模型评估来自三种标本的不同菌种之间流行率的差异,并使用卡方检验评估多重耐药菌(MDRO)和非MDRO之间的差异。

结果

IncN、IncP、IncQ、IncW和IncA/C复制子的平均阳性检测率分别为4.3%、3.7%、3.0%、2.6%和1.9%,从高到低排列。从伤口和尿液中采集的标本中,所有五种BHR质粒的分布没有显著差异,尽管两者均显著高于痰液标本。对于肠杆菌科,MDRO中所有五种BHR质粒的流行率均显著高于非MDRO;然而,在非发酵革兰氏阴性杆菌(NFGNB)中未观察到显著差异。

结论

BHR IncA/C、IncN、IncP、IncQ和IncW质粒在从伤口和尿液标本分离的杆菌中比在痰液中更常见,在从住院患者分离的大肠杆菌、肺炎克雷伯菌、奇异变形杆菌、阴沟肠杆菌、铜绿假单胞菌和鲍曼不动杆菌菌株中广泛存在。对于肠杆菌科,MDRO中的流行率高于非MDRO,但对于NFGNB没有显著差异。

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