| 摘要: |
| 目的:研究大环内酯类耐药卡他莫拉菌的临床特点、药敏及耐药机制。方法:留取住院社区获得性下呼吸道感染患儿痰标本分离48株卡他莫拉菌,建株保存,分析卡他莫拉菌对大环内酯类敏感及耐药患儿的临床特点;采用K-B法进行药敏试验,头孢硝噻吩色原法测定茁鄄内酰胺酶,聚合酶链反应(PCR)及序列分析大环内酯类耐药机制。结果: 48株卡他莫拉菌β-内酰胺酶的产酶率为93.8%(45/48);卡他莫拉菌对红霉素和阿奇霉素耐药率分别为56.3%和41.7%。在23S rRNA突变位点检测中,A2982T、C3132T 等突变位点与大环内酯类耐药可能有关,未发现ermA、ermB、mefA 及merE等耐药基因。耐药组更多表现为喘息、肺部喘鸣音,与敏感组比较差异有统计学意义(P<0.05)。结论:卡他莫拉菌β-内酰胺酶的产酶率、对大环内酯类的耐药性均日益增加,大环内酯类耐药组患儿更多表现为喘息,卡他莫拉菌耐药机制可能与23S rRNA位点发生突变有关。 |
| 关键词: 卡他莫拉菌 大环内酯类 耐药性 23S rRNA 基因突变 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.09.011 |
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| 基金项目: |
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| Clinical Characteristics of Gene Mutations in 23S rRNA of Macrolide-Resistant Moraxella Catarrhalis |
| Chen Xia1 , Wang Caihong2 , Yang Haijuan1 , Wu Jiahui1 , Chen Yulan1 , Cao Sufen1 |
| (1. Langfang People's Hospital, Hebei Langfang 065000, China; 2. China National Petroleum Corporation Center Hospital, Hebei Langfang 065000, China) |
| Abstract: |
| Objective: To investigate the clinical characteristics, drug sensitivity and resistance mechanisms of macrolide-resistant Moraxella catarrhalis. Methods: Forty eight Moraxella catarrhalis specimens from hospitalized community-acquired lower respiratory tract infections in children were collected, sensitivity to macrolides and clinical features of resistant children were analyzed. The K-B method was applied in drug sensitive test, nitrocefin test was used to measure β-lactamase, polymerase chain reaction (PCR) and sequencing were used to analyze mechanism of macrolide-resistance. Results: There were 93.8% (45/48) Moraxella catarrhalis produced β-lactamase. There were 56.3% erythromycin-resistant Moraxella catarrhalis, 41.7% azithromycin-resistant Moraxella catarrhalis. In the 23S rRNA mutation detection, A2982T, C3132T and other mutation may lead to macrolide-resistance, and resistance gene such as ermA, ermB, mefA, merE etc. were not found. Children of resistance performs group had more likely wheezing, there was significant difference between the sensitivity and resistance group (P <0.05). Conclusion: Resistance of Moraxella catarrhalis to macrolides and β-lactamases production rate are increasing. Children of macrolide-resistant group perform more likely wheezing.Mechanism of macrolide-resistance may be associated with 23S rRNA mutation. |
| Key words: Moraxella catarrhalis macrolide resistance 23S rRNA gene mutation |
