摘要
目的研究探讨广州市GBS阳性孕妇GBS致病菌株的基因分型及其各种基因型的流行分布情况,为GBS致病菌株的快速分子诊断及其流行病学监测提供一定的理论依据和方法。方法在广州市采用多阶段分层整体抽样的方法从2015年01月~12月就诊的GBS阳性孕妇的生殖道中收集的标本,药敏质控标准菌株:肺炎链球菌(ATCC49619)及金黄色葡萄球菌(ATCC25923),采取菌株培养、鉴定、DNA提取、PCR试验、基因检测等方法,通过相关软件进行相关数据分析,分析GBS致病菌株的基因分型及分子流行病学状况。结果共收集分泌物标本2 812份,经菌株鉴定分离出178株GBS致病菌株,其检出率为6.33%。GBS致病菌株对利奈唑烷、万古霉素、青霉素、呋喃妥因等抗菌药物耐药率均为0,对氨苄青霉素、环丙沙星、莫西沙星及左旋氧氟沙星部分耐药,其耐药率分别为1.1%,16.9%18.0%及22.5%,而GBS致病菌株对红霉素、克林霉素等抗菌药物均出现了较高的耐药率,其耐药率分别为50.6%,47.8%(其中红霉素诱导克林霉素耐药有20例,占23.5%)和73.0%。65株GBS检测出mreA基因,56株GBS检测出ermB基因,36株GBS检测出mefA基因,28株GBS检测出mefE基因,5株GBS检测出ermA基因,ermC基因未被检测出。其中携带5种耐药基因的有3株(1.69%),携带4种耐药基因的有15株(8.43%),携带3种耐药基因的有19株(10.67%),携带2种耐药基因的有25株(14.04%),携带1种耐药基因的有5株(2.81%),不携带耐药基因的有1株(0.56%)。五种耐药基因的核苷酸序列,其同源性均为100%,无基因突变发生。结论 GBS致病株耐药基因主要是mreA,ermA,ermB,mrfA,mefE,且其核苷酸序列同源性为100%,临床上需加强耐药基因分子水平检测,指导临床更加合理科学的用药。
Objective To study genotyping and molecular epidemiology distribution of GBS pathogenic strains of GBS positive pregnant women in Guangzhou, for GBS pathogenic strains of rapid molecular diagnosis and epidemiological surveillance pro- vide certain theoretical basis and method. Methods In the Guangzhou area,used multi stage stratified sampling method col- lecting GBS positive pregnant women＇s reproductive tract specimens from January to December 2015, drug sensitivity quality control standard strains ： Streptococcus pneumoniae （ATCC49619） and Staphylococcus aureus （ATCC25923）, took culture of bacterial, strain, identification, DNA extraction, PCR, gene detection method, through the relevant software for data analy- sis,analyzed GBS strains of gene and molecular epidemiology. Results In the study,collected 2 812 samples of secretions,af- ter identification of strains isolated from 178 strains of pathogenic GBS strains, the detection rate was 6.33%. GBS patho- genic strains to tinezolid vancomycin, penicillin, nitrfurantion and other antimicrobial drug resistance rate was 0,GBS parho- genie strains to ampicillin,ciprfloxaein moxifloxacin and levofloxacintesistant parts, the restance rates were 1.1 %,16.9 %, 18.0 %and 22.5 %, but GBS pathogenic strains to erythromycin, clindamycin tetracydine antibiotics showed a high resistance rate, the resistance rates were 50.6 %,47.8 % （of which 20 cases of erythromycin induced clindamycin resistance accouted for 23.5%） and 73.0%. Among them,65 strains of GBS detected the mreA gene,56 strains of GBS detected the ermB gene,36 strains of GBS detected the mefA gene,28 strains of GBS detected the merE gene,5 strains of GBS detected the ermA gene, ermC gene was not detected in the gene. Among them, carried five multidrug resistance gene of 3 strains （1.69%） and 4 kinds of resistant gene carried with 15 strains （8. 43%） ,carried three resistance genes of 19 strains （10.67%） ,2 kinds of resistant gene carrying a 25 strains （14.04%）,carried the resistance gene of 5 strains （2.81%）,did not carry resistance gene of 1 strain （0.56%）. The nucleotide sequences of the five drug resistance genes were 100% ,and no gene mutation pc-curred. Conclusion The main GBS disease resistant gene was mreA, ermA, ermB, mrfA, merE and its nucleotide sequence homology was 100%. The clinical need to strengthen the detection of resistant gene and molecular level and guide clinical more scientific and rational drug use.
出处
《现代检验医学杂志》
CAS
2017年第1期87-90,共4页
Journal of Modern Laboratory Medicine
基金
广东省广州市医药卫生科技项目(项目编号:20161A010026)
关键词
GBS致病菌株
基因分型
GBS阳性孕妇
分子流行病学调查
GBS pathogenic strain
genotyping
GBS positive pregnant women
molecular epidemiology investigation
作者简介
容莉莉（1982-），女，本科，主管技师，专业：检验，E—mail：lilyrong@yeah．net。
