住院患者分离的纹带棒状杆菌耐药性及同源性研究

摘要

目的：分析研究住院患者分离的纹带棒状杆菌耐药性及同源性。方法选取于2013年10月至2014年4月在该院住院患者58例，对患者不同部位分离的纹带棒状杆菌58株，采用肉汤微量稀释法对患者进行体外药敏试验，对纹带棒状杆菌阳性患者的周边环境采用盐水棉拭子法进行采样，对分离的纹带棒状杆菌进行体外药敏试验；对58株纹带棒状杆菌采用脉冲场凝胶电泳法（PFGE）进行分子分型。结果纹带棒状杆菌聚集分布于2013年12月至2014年3月。药敏试验结果显示，四环素、红霉素、克林霉素、环丙沙星和青霉素这5种抗菌药物的最小抑菌浓度（MIC）≥64μg／mL ；万古霉素、利福平和庆大霉素的 MIC 均为0．5μg／mL ；只有1株分离的纹带棒状杆菌对除克林霉素之外的所用抗菌药物全部敏感。 PFGE 分型结果显示，50株纹带棒状杆菌共分为7个不同基因型，其中0002型和0006型这两种基因型为优势型。从同期住院的同一病房患者身上分离出的纹带棒状杆菌同源性高。环境采样结果显示，纹带棒状杆菌分离阳性率达43．48％（10／23）。结论住院患者分离纹带棒状杆菌呈多重耐药性，且从不同患者身上分离出的菌株同源性极高。%Objective To analyze the drug resistance and homology of Corynebacterium striatum isolated from inpatients .Methods 58 inpatients in our hospital from 2013 October to 2014 April were selected .58 strains Coryne‐bacterium striatum were isolated from different parts .The in vitro drug susceptibility test was performed by using the broth microdilution method .The surround environment in the patients with Corynebacterium striatum positive were sampled by saline cotton swab .The isolated Corynebacterium striatum was performed the in vitro drug susceptibility test ;58 strains of Corynebacterium striatum were performed the molecular typing by using the pulsed field gel elec‐trophoresis (PFGE) .Results Corynebacterium striatum aggregation was distributed in December 2013 ,January , February and March 2014 .The results of drug susceptibility test showed that the minimal inhibitory concentrations (MIC) of the 5 kinds of antibacterial drugs ,tetracycline ,erythromycin ,clindamycin ,ciprofloxacin and penicillin ,were more than or equal to 64 μg/mL ;MIC of vancomycin ,rifampicin and gentamicin all were 0 .5 μg/mL ;only 1 isolated strain of Corynebacterium striatum was sensitive to all antibacterial drugs except for clindamycin .The pulsed field gel electrophoresis typing results showed that 50 strains of Corynebacterium striatum were divided into 7 different geno‐types ,in which 0002 genotype and 0006 genotype were predominant type .Corynebacterium striatum isolated from the patients in the same ward during the corresponding period had high homology .The environmental sampling results showed that the isolation positive rate of Corynebacterium striatum reached 43 .48% (10/23) .Conclusion Coryne‐bacterium striatum isolated from inpatients presents multi‐drug resistance ,and which isolated from different in pa‐tients has extremely high homology .