威海地区幽门螺杆菌耐药谱表型及遗传特征分析

目的研究威海地区的幽门螺杆菌对阿莫西林(AMX)、克拉霉素(CLA)、甲硝唑(MTZ)和四环素(TET)的耐药性表型和基因型。方法对172株分离自消化不良患者的幽门螺杆菌进行药敏试验检测,采用PCR法对甲硝唑耐药菌株进行rdx A和frx A基因的扩增。结果共检出耐4株阿莫西林耐药株(2.3%)、16株克拉霉素耐药株(9.3%),以及90株甲硝唑耐药株(52.3%)和6株四环素耐药株(3.5%)。所有甲硝唑耐药菌株中的rdx A基因发生了改变并直接导致Rdx A蛋白的氨基酸序列发生变化。在52株甲硝唑耐药株中发现frx A基因的错义突变,而在14株甲硝唑耐药株中检出了由于移码突变造成的frx A基因表达的提前终止。结论本地区的幽门螺杆菌对甲硝唑有较高的耐药率,与该类细菌染色体中rdx A和frx A基因的突变有关。     

随机扩增多态性DNA分析院内感染的铜绿假单胞菌

目的 运用随机扩增多态性DNA(RAPD)基因分型技术监测铜绿假单胞菌(PA)的医院感染情况,了解耐药表型与RAPD基因型关系,为确定院内交叉感染发生及院感控制提供依据.方法 对10例ICU患者连续多次采样分离出的48株PA进行RAPD基因分型和药物敏感性试验.结果 48株PA共分出9个基因型.6例患者为单一RAPD型PA菌株感染,4例患者检出2种RAPD 型,有3组患者分别检出同型RAPD.耐药性最高的是环丙沙星(75%),其次是左氧氟沙星(73%),耐药性最低的为美洛培南(31%).结论 耐药表型与RAPD基因型之间不存在相关性;RAPD分型快速简单,对于流行病学调查确定院内交叉感染或流行具有重要意义.     

鲍曼不动杆菌IRS-PCR基因分型研究

目的 用低频限制性位点聚合酶链反应(IRS-PCR)对鲍曼不动杆菌进行基因分型,分析基因型与鲍曼不动杆菌耐药谱的关系,并初步探讨其在分子流行病学中的作用.方法 随机收集2008年8月至2009年8月临床分离的73株鲍曼不动杆菌,采用K-B法进行药物敏感试验确定鲍曼不动杆菌耐药谱;同时利用IRS-PCR对此73株鲍曼不动杆菌进行基因分型;并分析IRS-PCR分型与鲍曼不动耐药谱的关系;结合IRS-PCR分型结果与73株鲍曼不动杆菌感染病例的临床资料,分析在此时间段鲍曼不动杆菌在我院流行感染的情况.结果 药物敏感试验将73株鲍曼不动杆菌菌株分为A1(19株全耐药型)和A2 ～ A31(54株耐药谱型)31个药敏谱.IRS-PCR法将其分为A～W共23个基因型,其中A、C、B、D和E型为5种优势菌株,分别为14、11、10、8和6株.对比研究发现A1型菌株(15/19)主要集中在基因型A、C、D内,而基因型B包含A15型耐药菌株9株(69.2％),基因型E包含A3型耐药菌株3株(42.9％).A基因型在院内特别是ICU中心引起2次爆发流行,而C和D型主要在呼吸内科引起感染.结论 IRS-PCR基因分型与药敏分型有较高的一致性,且IRS-PCR基因分型在早期发现和预防感染暴发流行方面优于药敏分型.     

鲍曼不动杆菌临床分离株的耐药性及同源性分析

目的 通过对重庆医科大学附属第二医院近4年临床分离的103株鲍曼不动杆菌的耐药性和同源性分析,了解该院鲍曼不动杆菌的耐药性特点及院内感染流行状况.方法 2008年至2011年间该院临床科室分离的103株鲍曼不动杆菌,进行药敏试验并对耐药性分析;提取细菌基因组DNA,以随机扩增DNA多态性(RAPD)方法进行基因分型.结果 药敏试验结果显示分离出的103株菌呈现出高耐药率及多重耐药率的特点,其中对左氧氟沙星和亚胺培南的耐药性最低,分别为69.9％和57.3％.103株多重耐药鲍曼不动杆菌用RAPD分型共分为16种基因型:A～P,其中A型84株,为主要流行型别;B型3株;C型、G型各2株;其余12型各1株.结论 该院鲍曼不动杆菌具有多重耐药及高耐药率,可能存在以A型鲍曼不动杆菌克隆株传播方式的院内流行,临床上应加强对A型鲍曼不动杆菌的监控,采取有效的措施以预防院内感染的爆发流行.     

淋病奈瑟菌临床菌株porB基因分型及其突变与耐药相关性研究

了解淋病奈瑟菌临床菌株porB基因型及其产物120和121位氨基酸突变与耐药的相关性。采用多重PCR(mPCR)检测淋病奈瑟菌临床菌株porB基因型,扩增产物测序后分析其编码蛋白的120和121位氨基酸突变情况,二倍平皿稀释法检测临床菌株对青霉素和四环素的耐药性。184株淋病奈瑟菌临床菌株中,99.5%(183/184)检出porB基因,其中61株(33.3%)为porB1A基因型,122株(66.7%)为porB1B基因型。122株porB1B基因型菌株中,117株(95.9%)porB基因120和/或121位氨基酸发生突变,5株(4.1%)porB1B及所有porB1A基因型菌株porB基因120和/或121位氨基酸未突变。117株porB基因120和/或121位氨基酸突变的porB1B基因型菌株中,97.4%(114/117)和95.7%(112/117)分别对青霉素和四环素耐药,2.6%菌株(3/117)对青霉素和四环素敏感。61株porB1A基因型菌株中,仅有2株(3.3%)对青霉素和四环素耐药。研究中采用的mPCR能快速、准确地对淋病奈瑟菌临床菌株porB基因进行分型,这些菌株主要携带porB1B基因且该基因型菌株对青霉素和四环素耐药率显著高于porB1A基因型(P<0.01),该耐药性与porB1B基因120和/或121位氨基酸突变密切相关。     

48例消化性溃疡患者幽门螺杆菌的耐药性调查

对幽门螺杆菌 (Helicobacterpylori ,Hp)临床分离株进行药物敏感性试验及耐药性分析 ,为探求幽门螺杆菌感染的根除疗法提供依据。运用微需氧培养方法 ,从胃镜活检标本中分离幽门螺杆菌 ,利用琼脂稀释法测定幽门螺杆菌对抗生素的敏感性试验 ,将 2 1株Hp临床分离株进行 7种抗菌药物的敏感性及耐药性调查。从 4 8例消化性溃疡患者胃镜活检标本中分离出 2 1株幽门螺杆菌。 2 1株幽门螺杆菌对阿莫西林MIC范围 0 .5～ 8mg/L ,无耐药菌株 ;克拉霉素、替硝唑的MIC范围分别为 0 .12 5～ 0 .5mg/L和 4～ 8mg/L ,耐药率均为 4 .76 % ;四环素、利福平的MIC范围分别为 0 .5～ 1mg/L和 1～ 6 4mg/L ,耐药率分别为 4 .76 % ,9.5 2 % ;甲硝唑的MIC为 16～ 12 8mg/L ,红霉素的MIC为 0 .5～ 12 8mg/L ,耐药率较高 ,分别为 2 3.89%和5 7.15 %。此次分离的Hp对阿莫西林、克拉霉素、替硝唑有较高的敏感性 ;而对甲硝唑及红霉素耐药率高 ,应避免应用 ;阿莫西林、克拉霉素可作为本地区治疗Hp感染的主要药物 ;四环素、利福平可用于一线治疗失败后二线治疗 ;替硝唑可替代甲硝唑用于Hp的根除治疗。     

张家口地区木糖氧化无色杆菌耐药性的相关基因分析

目的：了解张家口地区木糖氧化无色杆菌耐药性的相关基因的基因型别,为临床合理使用抗生素提供实验依据。方法：应用改良三维试验法筛选耐β-内酰胺类药物的菌株,再结合PCR技术和序列测定检测耐药菌ESBLs和AmpC酶的基因型别,最后进行统计学分析。结果：2010年12月~2011年12月本地区临床分离的48株木糖无色杆菌菌株中有32株对β-内酰胺类药物耐药,检出率高达66.7%,其中14株单产ESBLs,5株单产AmpC酶,9株同时产ESBLs和AmpC酶,4株为未知型菌株;筛选出的耐药菌中有24株PCR结果阳性,分属于不同耐药基因型并发现存在多重耐药基因。ESBLs以TEM型检出率最高,均为TEM-1亚型;AmpC酶检出率也较高,均为DHA-1型;多重耐药基因TEM＋CTX-M-1＋AmpC检出率最高。结论：张家口地区木糖氧化无色杆菌的耐药现象严重,临床上应严格掌握头抱菌素类药物的使用以取得更好的治疗效果。     

万古霉素耐药肠球菌基因分型及耐药性分析

目的了解本地区万古霉素耐药肠球菌(Vancomycin resistant Enterococci,VRE)耐药基因型别及耐药性,为临床治疗提供依据。方法用PCR方法检测56株VRE的耐药基因vanA、vanB、vanC、vanD、vanE和vanG;用K-B法检测其对临床常用14种抗菌药物的药敏,并用肉汤稀释法检测万古霉素和替考拉宁的药敏。结果 56株VRE中,vanA阳性的43株;vanB、vanC、vanD、vanE和vanG阳性0株;未检测到万古霉素耐药相关基因的13株。2011-2014年万古霉素和替考拉宁的MIC值呈逐年向左漂移趋势,与同期替考拉宁的使用有关。结论本研究所收集VRE对万古霉素的耐药大部分为高水平耐药,所携带的耐药基因类型主要为vanA,另有其他未知基因型以及少数vanA阳性但是表现为万古霉素敏感菌株。     

基于全基因组关联分析研究粪肠球菌发酵食品分离株的耐药性

【目的】研究15株分离自自然发酵食品的粪肠球菌(Enterococcus faecalis)和1株粪肠球菌模式株对15种(1种β-内酰胺类和14种非β-内酰胺类)抗生素的耐药性,并通过菌株耐药表型与基因型的关联分析找到粪肠球菌潜在的耐药基因。【方法】利用微量肉汤稀释法检测试验菌株对15种抗生素的耐药性,运用Scoary软件进行表型与基因型的关联分析。【结果】16株粪肠球菌对卡那霉素、万古霉素、利奈唑胺和红霉素100%敏感;对其余11种抗生素均表现出不同程度的耐药,其中对克林霉素为100%耐药。基因组关联分析发现了9个功能基因与5种抗生素(氯霉素、环丙沙星、甲氧苄啶、新霉素和四环素)存在显著相关关系,其中基因FAM000296和FAM005768与氯霉素、甲氧苄啶和环丙沙星的耐药性有关。进一步分析发现基因FAM000296和FAM005768同被注释为Sec G,但基因FAM005768与基因FAM000296相比在3′端丢失了21个碱基。【结论】分离自自然发酵食品的粪肠球菌对多种抗生素具有耐药性,其基因组中携带有潜在的耐药基因。因此,对分离自自然发酵食品的粪肠球菌需要进行全面的安全性评估后方可考虑应用。     

全耐药鲍曼不动杆菌分子分型和分子流行病学调查

重复片段引物PCR和随机扩增多态性DNA(RAPD)技术对临床分离全耐药不动杆菌分子分型,并进行流行病学调查.从ICU病房感染多重耐药不动杆菌患者的标本分离不动杆菌,碱裂解法提取全基因组,重复片段引物PCR(Rep-PCR)和随机引物扩增(RAPD),对8株临床分离的全耐药菌基因分型,并与生物学分型和质粒分型比较,调查医院流行全耐药菌的基因型.结果显示,8株分离菌经两对重复片段引物分型可分为6种和4种基因型,经随机引物分型为4种和3种基因型,经质粒分型可分为2种基因型,生物学分型归属为1种表型.PCR方法用于全耐药不动杆菌分子分型简便易行,重复性好,适合医院感染流行病学调查,本医院同一部门出现多种基因型,各科室间不存在交叉传染.     

Metabolic activities of metronidazole-sensitive and -resistant strains of Helicobacter pylori: repression of pyruvate oxidoreductase and expression of isocitrate lyase activity correlate with resistance.

In this study, we compared metronidazole (Mtz)-sensitive and -resistant strains of Helicobacter pylori for metabolic differences that might correlate with drug resistance. Included in this study was an isogenic Mtz(r) strain, HP1107, that was constructed by transforming genomic DNA from Mtz(r) strain HP439 into Mtz(s) strain HP500. Enzyme activities were also measured for Mtz(r) strains grown in the presence or absence of 18 micrograms of metronidazole per ml (ca. one-half of the MIC). These studies confirmed the presence of the Embden-Meyerhof-Parnas, Entner-Doudoroff, and pentose pathways. H. pylori strains expressed enzymatic activities indicative of a complete and active Krebs cycle. All strains expressed pyruvate oxidoreductase (POR) and alpha-ketoglutarate oxidoreductase (KOR) as measured with the redox-active dye benzyl viologen (30 to 96 nmol/min/mg of protein for POR and 30 nmol/min/mg of protein for KOR). When grown in the presence of Mtz at > or = 3.5 micrograms/ml, Mtz(r) strains expressed no detectable POR or KOR activity. The apparent repression of POR and KOR activities by Mtz affected bacterial growth as manifest by extended lag periods and growth yield reductions of > 30%. A dose-dependent relationship was demonstrated between the metronidazole concentration in the growth medium and the specific activity of POR measured in bacterial cell extracts. The observed repression was not due to inactivation of POR by Mtz. In addition to repression of POR and KOR activities, growth in the presence of Mtz also led to decreases in the activities of various Krebs cycle enzymes, including aconitase, isocitrate dehydrogenase and succinate dehydrogenase. All of the Mtz(r) strains examined expressed isocitrate lyase and malate synthase activities indicative of the glyoxylate bypass. No isocitrate lyase activity was detected in Mtz(s) strain HP500. Isocitrate lyase activity was expressed by HP500 following transformation to Mtz resistance (Mtz(r) strain HP1107) with DNA from an Mtz(r) strain. The results of this study suggest that Mtz resistance may be a recessive trait, possibly involving inactivation of a regulatory gene, that results in constitutive expression of isocitrate lyase. Repression of POR and KOR activities in response to low levels of Mtz may be a general response of H. pylori strains to Mtz, but only resistant strains manage to survive via activation of compensatory metabolic pathways.     

Sequential inactivation of rdxA (HP0954) and frxA (HP0642) nitroreductase genes causes moderate and high-level metronidazole resistance in Helicobacter pylori

Helicobacter pylori is a human-pathogenic bacterial species that is subdivided geographically, with different genotypes predominating in different parts of the world. Here we test and extend an earlier conclusion that metronidazole (Mtz) resistance is due to mutation in rdxA (HP0954), which encodes a nitroreductase that converts Mtz from prodrug to bactericidal agent. We found that (i) rdxA genes PCR amplified from 50 representative Mtz(r) strains from previously unstudied populations in Asia, South Africa, Europe, and the Americas could, in each case, transform Mtz(s) H. pylori to Mtz(r); (ii) Mtz(r) mutant derivatives of a cultured Mtz(s) strain resulted from mutation in rdxA; and (iii) transformation of Mtz(s) strains with rdxA-null alleles usually resulted in moderate level Mtz resistance (16 microg/ml). However, resistance to higher Mtz levels was common among clinical isolates, a result that implicates at least one additional gene. Expression in Escherichia coli of frxA (HP0642; flavin oxidoreductase), an rdxA paralog, made this normally resistant species Mtz(s), and frxA inactivation enhanced Mtz resistance in rdxA-deficient cells but had little effect on the Mtz susceptibility of rdxA(+) cells. Strains carrying frxA-null and rdxA-null alleles could mutate to even higher resistance, a result implicating one or more additional genes in residual Mtz susceptibility and hyperresistance. We conclude that most Mtz resistance in H. pylori depends on rdxA inactivation, that mutations in frxA can enhance resistance, and that genes that confer Mtz resistance without rdxA inactivation are rare or nonexistent in H. pylori populations.     

TaqMan-MGB 探针检测GSTP1外显子5SNP可行性研究

目的：评估TaqMan-MGB探针基因分型方法检测已知SNP的可行性,并与传统的PCR-RFLP方法比较。方法：高通量的TaqMan-MGB探针基因分型方法已被用来检测单核苷酸多态性（SNP）。在321倒样本中,同时用TaqMan-MGB探针基因分型方法和PCR—RFLP方法检测GSTP1外显子5SNP。结果：2种方法所得结果完全一致。野生型（AA）226例（70．4％）,杂合子（AG）92例（28．7％）,纯合突变型3例（O．9％）。结论：TaqMan-MGB探针基因分型方法是一种能快速、高度特异性、高度自动化检测SNP的方法。可用于大规模的基因分型。     

Enhanced bacterial efflux system is the first step to the development of metronidazole resistance in Helicobacter pylori

Although metronidazole (Mtz) is an important component of Helicobacter pylori eradication regimens, it has been pointed out that the increasing use of Mtz may result in increase in the incidence of Mtz-resistant strains. The present study was designed to examine the initial mechanism of resistance acquisition of H. pylori to Mtz. After 10 Mtz-susceptible strains were cultured on plates containing sub-inhibitory concentrations of Mtz, the MIC of Mtz for 9 of the 10 strains increased to levels of the Mtz-resistant strains. In the Mtz-resistance-induced strains, the expression of the TolC efflux pump (hefA) was significantly increased under Mtz exposure, without the reduction of the Mtz-reductive activity. Our finding suggests that overexpression of hefA may be the initial step in the acquisition of Mtz resistance in H. pylori.     

Metronidazole activation is mutagenic and causes DNA fragmentation in Helicobacter pylori and in Escherichia coli containing a cloned H. pylori RdxA(+) (Nitroreductase) gene

Much of the normal high sensitivity of wild-type Helicobacter pylori to metronidazole (Mtz) depends on rdxA (HP0954), a gene encoding a novel nitroreductase that catalyzes the conversion of Mtz from a harmless prodrug to a bactericidal agent. Here we report that levels of Mtz that partially inhibit growth stimulate forward mutation to rifampin resistance in rdxA(+) (Mtz(s)) and also in rdxA (Mtz(r)) H. pylori strains, and that expression of rdxA in Escherichia coli results in equivalent Mtz-induced mutation. A reversion test using defined lac tester strains of E. coli carrying rdxA(+) indicated that CG-to-GC transversions and AT-to-GC transitions are induced more frequently than other base substitutions. Alkaline gel electrophoretic tests showed that Mtz concentrations near or higher than the MIC for growth also caused DNA breakage in H. pylori and in E. coli carrying rdxA(+), suggesting that this damage may account for most of the bactericidal action of Mtz. Coculture of Mtz(s) H. pylori with E. coli (highly resistant to Mtz) in the presence of Mtz did not stimulate forward mutation in E. coli, indicating that the mutagenic and bactericidal products of Mtz metabolism do not diffuse significantly to neighboring (bystander) cells. Our results suggest that the widespread use of Mtz against other pathogens in people chronically infected with H. pylori may stimulate mutation and recombination in H. pylori, thereby speeding host-specific adaptation, the evolution of virulence, and the emergence of resistance against Mtz and other clinically useful antimicrobials.     

FecA1, a bacterial iron transporter, determines the survival of Helicobacter pylori in the stomach

Helicobacter pylori encodes a single iron-cofactored superoxide dismutase (SodB), which is regulated by the ferric uptake regulator (Fur). Ferrous ion (Fe(2+)) is necessary for the activation of SodB. The activity of SodB is an important determinant of the capability of H. pylori for long-term colonization of the stomach and of the development of metronidazole (Mtz) resistance of the bacterium. This study is conducted to characterize the Fe(2+)-supply mechanisms for the activation of SodB in H. pylori, which, as mentioned above, is associated with the host-colonization ability and Mtz resistance of H. pylori. In this study, we demonstrate that fecA1, a Fe(3+)-dicitrate transporter homolog, is an essential gene for SodB activation, but not for the biogenic activity of H. pylori. H. pylori with SodB inactivation by fecA1 deletion showed reduced resistance to H(2)O(2), reduced gastric mucosal-colonization ability in Mongolian gerbils, and also reduced resistance to Mtz. Our experiment demonstrated that FecA1 is an important determinant of the host-colonization ability and Mtz resistance of H. pylori through Fe(2+) supply to SodB, suggesting that FecA1 may be a possible target for the development of a novel bactericidal drug.     

Molecular analysis of methicillin-resistant staphylococci isolated from hospital patients and in the out-patient clinic

In this study, a molecular analysis of the methicillin-resistant coagulase-negative staphylococci strains was performed. The obtained results of the biochemical and drug resistant pattern investigations were insufficient to assess the relationship between the strains. Therefore genotyping by the restriction fragment length polymorphism analysis (PCR-RFLP) method was performed. Analyzed strains characterized presence of the mecA gene-PCR products. The PCR products were digested with DraI and TasI, and the fragments separated by agarose gel electrophoresis. Typing of the methicillin-resistant gene using PCR-RFLP showed that all MRCNS strains possess an identical restriction pattern of the mecA gene. This identical restriction pattern of the mecA gene in investigated strains may suggest an easy transfer of this gene between different staphylococci species and lead to the spreading of methicillin-resistant among hospital strains. Furthermore performing the comparison of different phenotype and genotype methods has shown that the PCR-RFLP method is quick and reliable, enabling the detection and estimation of the relationship between MRCNS strains.     

The rdxA gene plays a more major role than frxA gene mutation in high-level metronidazole resistance of Helicobacter pylori in Taiwan

BACKGROUND: Metronidazole-resistant H. pylori associating with mutations of rdxA or frxA is still a debated topic. This study investigates whether rdxA and frxA mutations of H. pylori accounted for the high MIC value (>/= 64 micro g/ml) of metronidazole (Mtz). MATERIAL AND METHODS: From 126 clinical H. pylori isolates, we examined 14 Mtz-sensitive, 18 Mtz-resistant H. pylori, and eight pairs of Mtz-sensitive and Mtz-resistant colonies simultaneously present within a single gastric biopsy. The paired strains from one single biopsy were proven identical by PCR-RFLP. MICs of Mtz were checked by the E-test and agar dilution method. The mutations of rdxA and frxA sequencing were matched with the Mtz-susceptible ATCC 26695 and J99. RESULTS: There were 89% (16/18) of Mtz-resistant isolates with mutation of RdxA. Half of the 14 Mtz-sensitive strains, all without mutation of RdxA, still contained truncation of FrxA. Within the paired isolates from a single biopsy, rdxA mutation (86%) was more common than frxA mutation (43%) in those isolates with high-level Mtz-resistant H. pylori. RdxA truncation was more prevalent in Mtz-resistant strains with high MICs than in those with low to moderate MICs (75% vs. 20%, p =.01, OR: 12, 95% CI: 1.8-81.7). CONCLUSION: Mutations in the rdxA gene rather than the frxA gene generally determine a high MIC level of Mtz-resistant H. pylori in Taiwan.     

双色荧光杂交芯片在检测 P 1A 1M P I 基C 因多态性中的应用

目的：应用一种新的高通量SNP检测方法-双色荧光杂交芯片技术检测CYPIA1 MspI基因多态性。方法：收集江苏汉族人群原发性肺癌患者75例和相应对照77例,应用双色荧光杂交芯片技术检测了152例样本的CYPIAI基因MspI基因多态性,并应用PCR-RFLP技术验证双色荧光杂交芯片的特异性。结果：152例样本的CYPIAI基因双色荧光杂交芯片技术分型结果与PCR-RFLP结果完全相符,两种方法的基因型分型结果具有很好的一致性。结论：双色荧光杂交芯片技术是一个高通量SNP检测的良好工具,特异性高,在大规模人群SNP筛检中具有良好的发展前案。