摘要
目的探讨自噬相关分子Beclin1和LC3在糖尿病足多重耐药金黄色葡萄球菌感染中的作用。方法选取2017年3月至12月间杭州市余杭区第一人民医院收治的金黄色葡萄球菌感染的糖尿病足患者62例为糖尿病足感染组,同期在本院就诊的足部烧伤患者38例为对照组。分离、鉴定金黄色葡萄球菌并进行药敏试验,根据耐药情况将糖尿病足感染组患者进一步分为多重耐药组、非多重耐药组。免疫组化法检测足部创面肉芽组织中Beclin1和LC3表达水平,免疫荧光双染色法检测巨噬细胞中LC3表达水平。结果糖尿病足感染组患者糖化血红蛋白、白细胞计数、红细胞沉降率明显高于对照组,差异有统计学意义(P<0.05)。糖尿病足感染组62例患者中检出多重耐药金黄色葡萄球菌30例(48.39%);对照组38例患者中检出多重耐药金黄色葡萄球菌2例(5.26%);糖尿病足感染组多重耐药金黄色葡萄球菌检出率明显高于对照组,差异有统计学意义(P<0.05)。多重耐药组患者白细胞计数、中性粒细胞比率、C反应蛋白水平明显高于非多重耐药组,差异有统计学意义(P<0.05)。免疫组化检测显示,糖尿病足感染组创面肉芽组织中Beclin1、LC3表达水平明显低于对照组,差异有统计学意义(P<0.01);多重耐药组患者创面肉芽组织中Beclin1、LC3表达水平明显低于非多重耐药组患者,差异有统计学意义(P<0.05)。免疫荧光双染色检测显示,糖尿病足感染组患者创面肉芽组织中LC3、CD14共表达强度明显低于对照组。结论金黄色葡萄球菌感染的糖尿病足患者创面肉芽组织中Beclin1、LC3表达明显下降,且多重耐药金黄色葡萄球菌感染者下降更明显;糖尿病足患者金黄色葡萄球菌多重耐药性的发生与发展可能与自噬水平减弱有关。
Objective To investigate the role of autophagy-related molecules Beclin1 and LC3 in diabetic foot infection with multidrug resistant(MDR)Staphylococcus aureus.Methods From June 2016 to October 2017,62 patients with diabetic foot infected by Staphylococcus aureus were selected as the diabetic foot infection group,and 38 patients with foot burns were selected as the control group.Staphylococcus aureus isolation,identification and drug sensitivity test were carried out.According to drug resistance,the patients with diabetic foot infection were further divided into multidrug resistance group and non-multidrug resistance group.The granulation tissue of foot wound was collected and the expression of Beclin1 and LC3 was detected by immunohistochemistry.The expression of LC3 in macrophages was detected by immunofluorescence double staining.Results The levels of glycosylated hemoglobin,white blood cell count and erythrocyte sedimentation rate in diabetic foot infection group were significantly higher than those in control group(P<0.05).Multidrug-resistant Staphylococcus aureus was detected in 30 cases(48.39%)of 62 patients with diabetic foot infection,2 cases(5.26%)of 38 patients in the control group,and the detection rate of multidrug-resistant Staphylococcus aureus in the diabetic foot infection group was significantly higher than that in the control group(P<0.05).The white blood cell count,neutrophil ratio and C-reactive protein levels in MDR group were significantly higher than those in non-MDR group(P<0.05).Immunohistochemical examination showed that the expression levels of Beclin1 and LC3 in wound granulatin tissue of diabetic foot infection group were significantly lower than those in control group(P<0.01);the expression levels of Beclin1 and LC3 in wound granulation tissue of multidrug resistance group were significantly lower than those in non-multidrug resistance group(P<0.05).Immunofluorescence double staining showed that the co-expression intensity of LC3 and CD14 in wound granulation tissue of diabetic foot infection group was significantly lower than that of control group,suggesting that LC3 expression in macrophages was significantly reduced.Conclusions The expression of Beclin1 and LC3 in the wound granulation tissue of diabetic foot patients infected with Staphylococcus aureus decreased significantly,especially in those infected with multidrug resistant Staphylococcus aureus.The occurrence and development of multidrug resistance of Staphylococcus aureus in diabetic foot patients may be related to the decrease of autophagy level.
作者
黄晓菁
郑霄
葛乔波
Huang Xiaojng;Zheng Xiao;Ge Qiaobo(The First People′s Hospital of Yuhang District,Hangzhou City,Department of Infection,Yuhang District,the Second Affiliated Hospital of Medical College of Zhejiang University,Hangzhou 311100,China)
出处
《中国医师杂志》
CAS
2021年第6期836-841,共6页
Journal of Chinese Physician
