感染性心内膜炎患者的主要病原菌耐药基因检测

Detection of main pathogenic drug resistance genes in infectious endocarditis

目的分析感染性心内膜炎患者耐药表型与耐药基因的关系。方法收集感染性心内膜炎患者血培养分离的草绿色链球菌和葡萄球菌,提取DNA,用聚合酶链反应(PCR)法扩增检测耐药基因。结果草绿色链球菌扩增的基因为PBP1a、PBP2b和PBP2x,这3个基因主导β-内酰胺类抗菌药物耐药,葡萄球菌扩增基因为mecA和ermB,mecA基因可引起耐甲氧西林阳性,ermB基因主导大环内酯类耐药,该实验选取的5株草绿色链球菌未检测出PBP1a、PBP2b和PBP2x基因,葡萄球检测检测结果显示6、7、8、10号菌株mecA基因阳性,6、7、8、9号菌株ermB基因阳性。结论耐药基因检测可以对临床感染性心内膜炎患者早期用药起到指导作用。

Objective By detecting the resistance genes of streptococcus pneumoniae and staphylococcus aureus isolated from blood cultures of patients with infective endocarditis,to analyze the relationship between the resistance phenotype and the resistance gene,and to guide clinical rational use of antimicrobial agents.Methods The streptococcus pneumoniae and staphylococcus aureus isolated from blood cultures of patients with infective endocarditis were collected.DNA was extracted and amplified by PCR.Results Streptococcus viridans were amplified by PBP1 a,PBP2 band PBP2 x,which dominatedβ-lactam antibiotics.Staphylococcus aureus amplification gene mecA and ermB,mecA gene caused methicillin-resistant,ermB gene dominant macrocyclic lipid resistance.The PBP1 a,PBP2 band PBP2 xgenes were not detected in 5 strains of streptococcus viridans,the detection results of grape ball showed that 6,7,8 and 10 were positive for mecA,and 6,7,8 and 9 were positive for ermB gene.Conclusion According to the experimental results,it can be seen that the initial conditions of the experiment are mature,can be further collected samples for testing and study the consistency of bacterial resistance and gene to guide the rational use of drugs in the early stage.