摘要
目的探讨多重药耐药医院获得性嗜麦芽窄食单胞菌(SMA)耐药途径阻断后的药敏情况,为其临床治疗与合理用药提供试验依据和思路。方法选取2013年11月至2014年10月临床分离的SMA 87株作为监测对象,通过阻断SMA耐药性的TopoⅡα途径,来观察其对医院获得性SMA多重药耐药性的生长、增殖及转移的抑制作用。结果 SMA菌株检测在呼吸科检出率最高,为25.29%,高于其他科室来源菌株检出率;在痰液中检出率最高,为35.63%,高于其他标本类型菌株,差异均有统计学意义(P<0.05);阻断SMA耐药性TopoⅡα途径前,87株SMA的药敏检测结果显示,对复方磺胺甲噁唑的敏感率最高,为87.36%;对亚胺培南耐药率最高,为100.00%,分别高于其他抗菌药物的敏感率和耐药率,差异均有统计学意义(P<0.05);阻断SMA耐药性TopoⅡα途径后,SMA对亚胺培南耐药率最高,为83.91%;对复方磺胺甲噁唑的敏感率最高,为94.25%,与阻断SMA耐药性TopoⅡα途径前比较,差异无统计学意义(P>0.05);氨曲南、头孢吡肟、亚胺培南的敏感性较阻断SMA耐药性TopoⅡα途径前增加,耐药性下降,差异均有统计学意义(P<0.05)。结论通过阻断SMA耐药性的TopoⅡα途径来沉默基因的表达,对医院获得性SMA耐药性的生长、增殖及转移有一定抑制作用,值得临床推广。
Objective To investigate the drug susceptibility situation after blocking TopoⅡα drug resistance pathway in multi‐drug resistant hospital‐acquired Stenotrophomonas maltophilia （SMA） to provide the experimental evidence and thinking for its clinical treatment and rational drug use .Methods 87 clinically isolated strains of SMA in our hospital from November 2013 to October 2014 were selected as the monitoring objects .By blocking the TopoⅡαpathway of SMA drug‐resistance ,its inhibiting role on the SMA growth ,proliferation and transferring was ob‐served .Results The detection rate of SMA strain was highest（25 .29% ） in the respiration department ,which was higher than the detection rate in the other departments ;the highest detection rate was in sputum（35 .63% ） ,which was higher than that in the other types of specimen ,the difference was statistically significant（P〈0 .05）;before bloc‐king the SMA drug‐resistance Topo Ⅱαpathway ,the drug susceptibility test results of 87 strains of SMA displayed that the sensitive rate to compound sulfamethoxazole was highest（87 .36% ） and the resistance rate to imipenem was highest （100 .00% ） ,which were higher than the sensitivity rate and resistance rate of other antibacterial drugs re‐spectively ,the differences were statistically significant（P〈0 .05）;after blocking the SMA drug resistance Topo Ⅱαpathway ,SMA had the highest resistance rate to imipenem（83 .91% ） and the highest sensitive rate（94 .25% ） to compound sulfamethoxazole ,the differences had no statistical significance compared with before blocking （P〉0 .05）;while the its sensitivity to aztreonam ,cefepime and imipenem was increased comparing with before blocking the SMA drug resistance Topo Ⅱαpathway ,and the drug resistance was dropped ,the differences were statistically significant （P〈0 .05） .Conclusion Silencing gene expression by blocking the Topo Ⅱαpathway of SMA has certain inhibitory effect on the growth ,proliferation and transferring of hospital acquired SMA ,which is worthy of clinical promotion .
出处
《检验医学与临床》
CAS
2015年第17期2510-2512,共3页
Laboratory Medicine and Clinic
基金
广东省深圳市科技计划项目(201303253)
关键词
多重耐药
医院获得性
嗜麦芽窄食单胞菌
耐药机制
multidrug-resistant
hospital-acquired
Stenotrophomonas maltophilia
resistance mechanisms
