發(fā)布時間：2018-02-20 20:25

  本文關(guān)鍵詞： 耐萬古霉素腸球菌 PCR 基因分型 耐藥性　出處：《南昌大學(xué)》2006年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景：腸球菌是條件致病菌，可導(dǎo)致人體多臟器的感染，不僅可引起尿路感染、皮膚軟組織感染，還可以引起危及生命的腹腔感染、敗血癥、心內(nèi)膜炎和腦膜炎等。近年來抗生素的廣泛應(yīng)用使腸球菌對β-內(nèi)酰胺類和高濃度氨基糖苷類抗生素的耐藥性增加，同時也出現(xiàn)耐萬古霉素腸球菌，多重耐藥的腸球菌的出現(xiàn)給臨床治療造成了極大的困難，因此應(yīng)廣泛引起重視。VRE在美國疾病控制中心(CDC)被列為第二院內(nèi)感染病原體，主要引起院內(nèi)感染，暴發(fā)流行多發(fā)生于重癥監(jiān)護(hù)病房和血液腫瘤病房等患有危重疾病和免疫功能低下的患者，所致感染發(fā)病率和死亡率高。 腸球菌對萬古霉素耐藥主要有5種基因型：VanA、VanB、VanC、VanD、VanE。臨床上的VRE大多屬于VanA型耐藥，VanA型耐藥的VRE對萬古霉素呈現(xiàn)高水平耐藥(MIC為64～512mg／L)，VanA型耐藥可以被萬古霉素和替考拉寧誘導(dǎo)產(chǎn)生。該型耐藥菌株多見于屎腸球菌和糞腸球菌，多由質(zhì)粒介導(dǎo)。VanB型耐藥株對替考拉寧敏感，，對萬古毒素的耐藥水平則有很大差異。同時也多見于屎腸球菌和糞腸球菌中。VanC型耐藥對萬古霉素呈天然低水平耐藥，對替考拉寧敏感。 耐萬古霉素腸球菌的基因分型鑒定對于其流行病學(xué)分析和感染控制具有重要意義。近年來，隨著分子生物學(xué)技術(shù)的發(fā)展，PCR技術(shù)已應(yīng)用于耐萬古霉素腸球的基因分型和相關(guān)研究。 目的：研究腸球菌臨床分離株的耐藥性，調(diào)查腸球菌對萬古霉素的耐藥狀況，檢測耐萬古霉素腸球菌的耐藥表型和基因型，并為臨床治療用藥、控制院內(nèi)感染及進(jìn)行流行病學(xué)調(diào)查提供依據(jù)。 方法：1．對江西省兒童醫(yī)院臨床標(biāo)本中分離的165株腸球菌采用微量肉湯稀釋法測定9種抗菌藥物的最低抑菌濃度(MIC)。2．對分離出來的萬古霉素不敏感菌株(MIC＞4μg／ml)應(yīng)用瓊脂平板法測試。3．對篩選出的萬古霉素不敏
[Abstract]:Background: Enterococcus is a conditional pathogen that can cause multiple organ infections, not only urinary tract infection, skin and soft tissue infection, but also life-threatening abdominal infection, septicemia. Endocarditis and meningitis, etc. In recent years, the widespread use of antibiotics has increased the resistance of Enterococcus to 尾 -lactams and high concentrations of aminoglycoside antibiotics, but also to vancomycin resistant Enterococcus. The emergence of multidrug resistant Enterococcus has caused great difficulties in clinical treatment. Therefore, it should be paid more attention to in the United States Centers for Disease Control and Control (CDC) is listed as the second nosocomial infection pathogen, mainly caused by nosocomial infection. Outbreaks mostly occur in intensive care units (ICU) and blood tumor rooms and other patients with critical diseases and low immune function, resulting in a high incidence of infection and mortality. There are mainly five genotypes of vancomycin resistance of Enterococcus to vancomycin:: VanAn VanBor VanCor Van DX VanE. Clinical VRE mostly belong to VanA resistant VRE with high level of vancomycin resistance to vancomycin. The MIC of vancomycin resistance to vancomycin is 64 ~ 512mg / L ~ (-1) / L ~ (-1) VanA which can be induced by vancomycin and teicoplanin. This type of drug-resistant strains are found in Enterococcus faecium and Enterococcus faecalis. The resistance to teicoplanin was sensitive to teicoplanin, and the resistance to vancomycin was different from that of panotoxin, and the resistance to vancomycin in Enterococcus faecium and Enterococcus faecalis showed a natural low level of resistance to vancomycin. Sensitive to teicoplanin. The genotyping and identification of vancomycin resistant Enterococcus is of great significance for its epidemiological analysis and infection control. In recent years, with the development of molecular biological technology, PCR has been applied to the genotyping and related research of vancomycin resistant enterococcus. Objective: to investigate the resistance of Enterococcus to vancomycin, to detect the phenotypes and genotypes of vancomycin resistant Enterococcus, and to study the resistance of Enterococcus to vancomycin. To control nosocomial infection and carry out epidemiological investigation. Methods: 1.The minimal inhibitory concentration (MIC) of 9 antimicrobial agents was determined by broth dilution method for 165 strains of Enterococcus isolated from children's hospital of Jiangxi Province. MIC > 4 渭 g / ml of vancomycin insensitive strain was used. Plate test. 3. Not sensitive to the screened vancomycin
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2006
【分類號】：R378.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張致平;抗耐藥菌藥物研究進(jìn)展[J];中國臨床藥理學(xué)雜志;2003年01期

2 上海市細(xì)菌耐藥性監(jiān)測協(xié)作組;上海地區(qū)細(xì)菌耐藥性監(jiān)測[J];中國抗感染化療雜志;2002年01期

3 張正,王賀,許淑珍,趙素蕊,劉文云,嚴(yán)薇;553株腸球菌藥敏結(jié)果分析[J];臨床檢驗雜志;2003年06期

4 糜祖煌;腸球菌的耐藥性及耐藥基因檢測[J];現(xiàn)代實用醫(yī)學(xué);2004年07期

5 劉貴建,許淑珍,馬越,李景云,張淑蘭,謝秀麗,劉振英,羅燕平;北京4家醫(yī)院臨床分離的腸球菌株的耐藥性分析[J];臨床和實驗醫(yī)學(xué)雜志;2002年04期

6 閻東輝,馬紀(jì)平,靳景圖;氨基糖苷類藥物高耐藥腸球菌的檢測及治療選藥建議[J];中華傳染病雜志;2001年01期

7 馬越,李景云,張新妹,張力,胡昌勤,金少鴻;2002年臨床常見細(xì)菌耐藥性監(jiān)測[J];中華檢驗醫(yī)學(xué)雜志;2004年01期

8 馬俊春，周紅;對高濃度氨基糖甙類耐藥菌株腸球菌的調(diào)查[J];中華醫(yī)學(xué)檢驗雜志;1995年03期

9 張群智,周惠平;腸球菌的耐藥性及脈沖場凝膠電泳分型研究[J];中華醫(yī)學(xué)檢驗雜志;1998年02期

10 王清濤,徐英春,王輝,陳民鈞,張秀珍,許淑珍,吳堅;腸球菌耐藥現(xiàn)狀調(diào)查及抗感染用藥探討[J];中華醫(yī)學(xué)檢驗雜志;1999年03期

本文編號：1519950