Fan Y F, Cui S Y, Zhang C, Xu X M
Department of Burns, Ningbo No.2 Hospital, Ningbo 315010, China.
Zhonghua Shao Shang Za Zhi. 2018 Feb 20;34(2):83-87. doi: 10.3760/cma.j.issn.1009-2587.2018.02.005.
To investigate the acquired drug-resistant genes and strains relationship in 40 strains of isolated from burn patients. Forty strains of isolated from burn patients hospitalized in our burn department from January 2014 to December 2015 were selected, with 20 strains from each year. Kirby-Bauer paper disk diffusion method was used to detect sensitivity of the isolated to 9 kinds of antibiotics of cefotaxime, ceftazidime, cefepime, imipenem, meropenem, gentamicin, amikacin, ciprofloxacin, and levofloxacin. Polymerase chain reaction was applied to detect 9 kinds of acquired β-lactamase antibiotics-resistant genes, outer membrane porin protein D2 genes, 12 kinds of acquired aminoglycosides antibiotics-resistant genes, and 6 kinds of acquired disinfectant-resistant genes and genetic marker genes of mobile genetic elements. Among the above genes, positive expression genes were verified by DNA sequencing and comparison. Sequences of twenty-eight acquired drug-resistant genes of the above 40 strains were analyzed by unweighted pair-group method with arithmetic means cluster analysis. Forty strains of were resistant to the above 9 kinds of antibiotics. Two kinds of acquired β-lactamase antibiotics-resistant genes of (TEM), (CARB), 5 kinds of acquired aminoglycosides antibiotics-resistant genes of , , ant, , and B, and 3 kinds of acquired disinfectant-resistant genes and genetic marker genes of mobile genetic elements of E△1-1, A, and were detected in 40 strains of with D2 gene deficiency. Forty strains aggregated obviously, with a total of 7 gene modes and 3 clones. Drug-resistant gene sequences of strains of number 2 to 4, 6 to 9, 11, 14, and 17 to 39 were similar and with close relationship. Drug-resistant gene sequences of number 12 and 13 strains were similar and with close relationship. Drug-resistant sequences of number 10 and 16 strains were similar and with close relationship. Genes of (TEM), (CARB), , , , B, E△1-1, A, and were prevalent in these strains of with D2 gene deficiency isolated from burn patients, which may play key roles in resistance of to β-lactamase, aminoglycoside, and quinolone antibiotics, and the drug-resistant phenotypes were in good coincidence with genotypes. strains isolated from burn patients were with similar acquired drug-resistant genes and close relationship.
为研究40株烧伤患者分离菌的获得性耐药基因与菌株关系。选取2014年1月至2015年12月在我院烧伤科住院患者分离的40株菌，每年各20株。采用 Kirby-Bauer 纸片扩散法检测分离菌对头孢噻肟、头孢他啶、头孢吡肟、亚胺培南、美罗培南、庆大霉素、阿米卡星、环丙沙星和左氧氟沙星9种抗生素的敏感性。应用聚合酶链反应检测9种获得性β-内酰胺酶抗生素耐药基因、外膜孔蛋白D2基因、12种获得性氨基糖苷类抗生素耐药基因、6种获得性消毒剂耐药基因及移动遗传元件的遗传标记基因。上述基因中，阳性表达基因经DNA测序及比对验证。对上述40株菌的28种获得性耐药基因序列采用非加权组平均法进行聚类分析。40株菌对上述9种抗生素均耐药。在40株D2基因缺失的菌中检测到2种获得性β-内酰胺酶抗生素耐药基因（TEM）、（CARB），5种获得性氨基糖苷类抗生素耐药基因、、ant、、B，以及3种获得性消毒剂耐药基因及移动遗传元件的遗传标记基因E△1-1、A、。40株菌明显聚集，共7种基因模式和3个克隆。第2至4、6至9、11、14以及17至39号菌株的耐药基因序列相似且关系密切。第12和13号菌株的耐药基因序列相似且关系密切。第10和16号菌株的耐药序列相似且关系密切。（TEM）、（CARB）、、、、B、E△1-1、A、基因在这些烧伤患者分离的D2基因缺失菌中普遍存在，可能在菌对β-内酰胺酶、氨基糖苷类和喹诺酮类抗生素的耐药中起关键作用，且耐药表型与基因型吻合良好。烧伤患者分离菌具有相似的获得性耐药基因且关系密切。
