浙江绍兴地区洋葱伯克霍尔德菌的基因分型及其耐药性

Genotypes and antibiotic resistance of Burkholderia cepacia in Shaoxing area of Zhejiang Province

目的分析浙江省绍兴地区洋葱伯克霍尔德菌（BC）的基因型及其耐药情况。方法对临床分离的80株BC复合群进行特异性引物PCR鉴定及hisA基因测序确认；应用随机扩增多态性DNA（RAPD）技术对确认的菌株进行基因分型，分析菌株间的同源性。对各型菌株行药敏试验。结果80株BC复合群recA基因PCR扩增全部阳性，经hisA基因测序确认BC复合群可分为6个菌种，其中最主要的是BC，占85．0％（68株）。RAPD技术将68株BC分为4个型别，A型45株，占72．6％，D型10株，C型和B型分别为5株和2株。药敏试验显示：A型和D型BC对青霉素类、头孢一至三代、氨基糖苷类和亚胺培南的50％抑菌浓度（MIC50）和90％抑菌浓度（MIC。）均较高，耐药率均≥80．0％，但本地区主要流行菌株（A型）对左氧氟沙星和甲氧苄啶／磺胺甲嗯唑具有较好的敏感性，耐药率为24．4％和28．9％。结论绍兴地区BC的基因型以A型为主，左氧氟沙星和甲氧苄啶／磺胺甲嗯唑可作为临床治疗BC感染的首选用药。

Objective To explore the genotypes of Burkholderia cepacia （BC） and its antibiotic resistance. Methods There were 80 BC complex strains of clinical isolates identified by PCR and sequenced by hisA gene. Using random amplified polymorphic DNA （RAPD） technique to identify genotype of the strains isolated and analyze the homology of the strains. At the same time, drug sensitive tests were conducted among different strains. Results Eighty strains of BC complex were all positive by recA PCR amplification, and the hisA gene sequencing confirmed that the compound was divided into 6 subtypes of which BC was the main type accounting for 85.0% （68 strains）. RAPD technology divided 68 strains of BC into 4 genotypes, including 45 strains of type A（72.6%）, 10 strains of type D, 5 strains of type B and 2 strains of type C. The drug sensitive tests showed that BC type A and D were highly resisted to MICs0 and MICg0 of penieillins, the first to third generation cephalosporins, amino glycosides, imipenem, to which the antibiotic resistance of type A and D were all more than 80.0%. However, type A strain that was locally popular had good sensibility to levofloxacin and trimethoprim/sulfamethoxazole to which the antibiotic resistance rates were 24.4% and 28.9%. Conclusions The major genotype of BC is type A in Shaoxin. Levofloxaein and trimethoprim/sulfamethoxazole can be the first choice to treat BC complex infection clinically.