耐药猪链球菌膜蛋白图谱分析及能量抑制剂对其敏感性的影响

为证实国内临床分离的动物源链球菌菌株中是否存在与红霉素耐药性相关的主动外排机制,选取含有mefA基因和ermB基因和不含mefA/ermB基因的链球菌耐药菌株和青霉素、红霉素均敏感菌株,在能量抑制剂氰氯苯腙(CCCP)存在时,采用棋盘法分析红霉素、阿齐霉素、替米考星、青霉素对分离菌MIC的影响,并采用SDS-PAGE电泳分析分离株的膜蛋白图谱.结果显示:CCCP可对含有mefA基因的耐药菌株产生影响,可增强其对红霉素、阿齐霉素的敏感性,但不影响其对替米考星和青霉素的敏感性.含有ermB基因、不含mefA/ermB基因的耐药菌,对红霉素、阿齐霉素、替米考星和青霉素的敏感性不受CCCP的影响.菌株膜蛋白的SDS-PAGE电泳图谱显示,含有mefA基因的耐药菌株与其他菌株的膜蛋白图谱差异较大,其膜蛋白条带多而深浓,在45 000处有明显的条带,其他菌株无该条带,推测该蛋白可能是膜主动外排的相关蛋白.本试验结果佐证了在链球菌内存在与红霉素耐药相关的主动外排机制.     

猪链球菌对大环内酯类抗生素的耐药性研究

为测定猪链球菌对大环内酯类抗生素的耐药性和相关耐药基因分布特点,分析分离株对大环内酯类抗生素耐药的分子机制。从河南等7省份不同猪场采集来的疑似猪链球菌患病猪的脑脊液、关节液、肝等部位分离、纯化疑似菌落,采用镜检、16S rRNA基因方法鉴定猪链球菌。采用肉汤微量稀释法检测分离猪链球菌对大环内酯类抗生素红霉素、泰乐菌素、替米考星的耐药情况,采用PCR方法检测相关耐药基因(包括编码核糖体甲基化酶的erm基因ermA、ermB、ermC、ermTR和介导外排泵机制的mefA、mefE及msrD基因)分布情况。最终从573份病料分离鉴定出猪链球菌165株,分离率为28.8%。药敏试验结果显示:猪链球菌对大环内酯类抗生素耐药率高达98.1%,对红霉素、泰乐菌素、替米考星耐药率分别达96.9%、95.1%、94.5%,有153株菌株对3种抗生素同时耐药。耐药基因检测发现大环内酯类耐药基因ermA、ermB、ermC、ermTR、mefA、mefE、msrD检出率分别为5.4%、81.8%、13.3%、6.6%、11.5%、7.2%、5.4%,其中ermB检出率最高。除发现有93株菌株仅携带1个耐药基因外,分别有30、17、2、1个菌株分别携带2、3、4、6个大环内酯类耐药基因。在检出耐药基因的菌株中有82.5%(118/143)的菌株仅携带erm基因,有13.9%(20/143)的菌株同时携带erm以及mef、msr基因,另有3%(5/143)的菌株仅携mef、msr基因。猪链球菌对大环内酯类药物广泛耐药,大环内酯类耐药基因在猪链球菌中广泛分布,细菌的耐药性和菌株耐药基因携带情况基本呈正相关。以ermB介导的核糖体23S rRNA甲基化耐药机制占主导地位,由mefA、mefE、msrD介导的外排泵机制亦存在于分离菌株中。     

泵抑制剂对诱导产ESBLs鸡大肠杆菌抗菌药物敏感性的影响

目的:探讨头孢曲松、头孢噻肟、头孢噻呋诱导鸡源大肠杆菌耐药产ESBLs与主动外排机制的关系。方法:用头孢曲松、头孢噻肟、头孢噻呋诱导3株临床分离菌和标准菌O78至产ESBLs;采用琼脂二倍稀释法观察外排泵抑制剂利血平和CCCP对诱导菌抗菌药物敏感性的影响。结果:加入利血平后,头孢曲松诱导后的菌株,阿米卡星、氟苯尼考、磷霉素组的MIC值变化有统计学差异,耐药率下降范围为25%～75%;头孢噻肟诱导后的菌株,头孢曲松、头孢噻呋、多西环素、氟苯尼考、磷霉素组MIC值变化有统计学差异,耐药率下降为25%～100%;头孢噻呋诱导后的菌株,其中头孢曲松、头孢噻呋、阿米卡星、氟苯尼考、磷霉素有统计学差异,耐药率下降为25%～100%。加入CCCP以后,仅头孢噻肟诱导后的菌株,头孢曲松MIC值变化差异显著;头孢噻呋诱导的菌株,头孢曲松、氟苯尼考差异显著;且耐药率下降范围均为25%～75%;利血平与抗菌药物合用后对诱导菌抗菌药物敏感性的影响高于CCCP。结论:3种头孢类药物诱导后的菌株对10种抗菌药物的外排表型存在差异;鸡大肠杆菌特异性耐药机制ESBLs可激活非特异性耐药机制外排表型的过度表达。     

鸭疫里默氏菌对氟喹诺酮药物的主动外排作用

为研究鸭疫里默氏菌对诺氟沙星、恩诺沙星、环丙沙星、氧氟沙星、左氧氟沙星等氟喹诺酮类药物的主动外排机制,测定25株鸭疫里默氏菌临床分离株对氟喹诺酮类药物的最低抑菌浓度（M IC ）,同时测定加入主动外排抑制剂碳酰氰间氯苯腙（CCCP）后的MIC ,对二者进行比较分析。结果表明,对5种氟喹诺酮类药物耐药的鸭疫里默氏菌比例分别为84％、72％、76％、68％和36％;76％的菌株同时耐受2种及以上药物。CCCP可以使耐药菌对除左氧氟沙星外药物的敏感性增加,提示主动外排在鸭疫里默氏菌对氟喹诺酮类药物的耐药机制中发挥重要的作用。     

外排泵抑制剂对鸡源大肠杆菌抗菌药物的外排表型特征的影响

为探讨主动外排泵在鸡大肠杆菌对抗菌药耐药中的作用和超广谱β-内酰胺酶与主动外排作用之间的关系,采用琼脂二倍稀释法检测主动外排抑制剂氰氯苯腙(CCCP)和利血平存在时,ESBLs阳性和阴性鸡大肠杆菌对10种抗菌药物的外排表型的变化。结果表明利血平缺乏与存在时,ESBLs阳性菌中,氨苄西林、头孢曲松、头孢噻肟、磷霉素对其MIC值的变化差异显著(P0.05),其对抗菌药物耐药率下降7.7%~30.7%,ES-BLs阴性菌对抗菌药物MIC值变化无统计学意义,且ESBLs阳性菌的外排筛选率高于ESBLs阴性菌;CCCP缺乏和存在时,头孢曲松、头孢噻肟、阿米卡星、磷霉素对ESBLs阳性菌MIC值变化差异显著(P0.05),对抗菌药物耐药率降低15.4%~46.12%,在ESBLs阴性菌对抗菌药物也无统计学意义;利血平与CCCP相比较在ESBLs阳性菌中外排阳性株的筛选无明显差异(P0.05),而在ESBLs阴性菌株差异显著(P0.05)。说明主动外排泵抑制剂CCCP和利血平与抗菌药物合用均可筛选出外排阳性株,但二者之间作用有很大的不同;ESBLs阳性菌的外排表型筛选率高于阴性菌,ESBLs阳性菌的多重耐药性可能是ESBLs与外排系统共同作用的结果,产ESBLs的特异性耐药与主动泵过度表达的非特异性耐药之间有协同关系。     

主动外排抑制剂对大肠杆菌耐药性逆转的研究

应用琼脂稀释法检测大肠杆菌质控株和耐药株在加入主动外排抑制剂碳酰氰间氯苯腙（CCCP）后对环丙沙星、恩诺沙星、四环素的最低抑菌浓度（MIC）变化情况。结果发现,在加入CCCP后,大肠杆菌质控株对上述3种抗菌药物的MIC无变化,多数耐药株对四环素MIC变化不大,而CCCP可使耐药株分别对环丙沙星和恩诺沙星的MIC变化较大,其中耐药菌S17对这两种药物的MIC均减小8倍。本研究结果提示,主动外排抑制剂CCCP与抗生素联合应用可降低大肠杆菌对抗生素耐药的发生率。     

体外诱导嗜水气单胞菌对喹诺酮类耐药及其耐药机制研究

【目的】探讨在亚抑菌浓度喹诺酮类药物培养后,嗜水气单胞菌Aeromonas hydrophila对喹诺酮类的药物敏感性变化及其耐药机制.【方法】以对喹诺酮类敏感的临床分离嗜水气单胞菌菌株和标准菌ATCC7966为研究对象,分别在含亚抑菌浓度萘啶酸(NAL)和环丙沙星(CIP)的培养基上逐步诱导培养.提取诱导菌的DNA,PCR扩增其gryA和parC基因,测序分析其喹诺酮类耐药决定区(QRDR)突变情况;测定诱导菌对诱导药物和11种非诱导药物的最小抑菌浓度(MIC)及添加外排泵抑制剂羰基氰化氯苯腙(CCCP)后的MIC,分析其敏感性变化与基因突变、外排作用的关系.【结果和结论】诱导后菌株对萘啶酸和环丙沙星的MIC分别提高了1 024和64 000倍,对非诱导药物也有不同程度提高;当萘啶酸和环丙沙星诱导浓度分别达到16和32μg/mL或以上后,诱导菌株gyrA基因编码的氨基酸分别发生Asp87→Tyr和Ser83→Arg的变化,但两者parC基因编码的氨基酸均没有发生突变;添加CCCP后,只有氟喹诺酮类药物的MIC值略有下降,提示嗜水气单胞菌对喹诺酮类耐药存在靶基因突变及主动外排作用等多种耐药机制.     

内蒙古无乳链球菌耐药性及四环素耐药基因检测

为了解内蒙古地区隐性乳房炎无乳链球菌分离株耐药性及耐药基因,采集内蒙古不同地区的规模化养殖场隐性乳房炎乳样,采用Kirby-Bauer(K-B)纸片扩散法测试分离株对16种抗菌药物的敏感性,PCR方法检测其耐药基因。结果显示:无乳链球菌对大部分抗生素较敏感。对其有较强抑菌作用的药物为:青霉素G、头孢噻肟、头孢唑啉、阿莫西林、红霉素、环丙沙星、恩诺沙星、氧氟沙星、林可霉素、呋喃妥因、万古霉素。其敏感性达到90%~100%。该菌株对四环素有较强的耐药性,耐药率达77.27%。PCR扩增四环素耐药基因tetM、tetO、tetK、tetL,结果显示22株无乳链球菌均含有tetM基因,其基因的检出率为100%。其中7株同时含有tetK基因,tetO、tetL基因未检出。     

猪链球菌表型耐药观察

为掌握当前猪链球菌耐药性情况,对分离鉴定出的81株链球菌菌株选用12种抗生素进行药敏试验.试验结果表明,链球菌对各种常规药物敏感率普遍较低,大多数菌株对先锋Ⅴ(85.1%)和利福平(81.4%)较敏感;其次是环丙沙星(66.6%)和恩诺沙星(63.0%) ;对青霉素、红霉素、庆大霉素和阿莫西林的敏感率则在45%左右;对克林霉素、林可霉素、强力霉素和四环素等敏感率极低,而且同种药物对不同来源菌株的敏感性均不相同.和之前试验进行比较发现:链球菌耐药谱变化快,如对先锋Ⅴ、利福平敏感率有所下降,而对部分抗生素如阿莫西林、红霉素和青霉素等敏感率则有所上升.     

动物源大肠埃希氏菌QnrS阳性株体内氟喹诺酮药物蓄积的研究

【目的】研究氟喹诺酮类药物在动物源大肠埃希氏菌QnrS阳性株体内蓄积量的变化规律,探讨主动外排机制在携QnrS菌株中的作用。【方法】采用肉汤微量稀释法测定QnrS阳性株对氟喹诺酮类药物的MIC,荧光测定法检测盐酸环丙沙星在QnrS阳性株体内浓度的变化及能量抑制剂碳酰氰间氯苯腙(CCCP)对菌体内药物蓄积的影响。【结果】动物源大肠埃希氏菌QnrS阳性株对氟喹诺酮药物的敏感性存在明显差异,均对盐酸环丙沙星的蓄积呈能量依赖性降低,其中以耐药株体内的药物浓度降低最为明显。加入能量抑制剂后,耐药株体内的药物浓度上升程度明显高于敏感株,但均达不到标准株体内药物浓度水平。【结论】主动外排泵的激活,使受试菌体内盐酸环丙沙星减少并低于有效浓度,从而影响QnrS介导的氟喹诺酮类耐药性。     

Erythromycin Resistance of Streptococcus suis Isolates In Vivo

In order to study erythromycin resistance of Streptococcus suis under high or low concentration of selective drug pressure, Streptococcus suis strain LN was isolated from a diseased pig in 2005 and showed to be susceptible to erythromycin as determined by disc diffusion and tube dilution tests. In this study, clean level rabbits were divided into three groups of six rabbits each, including a prevention dosage group, a treatment dosage group, and a control group. After injection with S. suis strain LN, erythromycin （20 μg mL^-1） was taken orally in the prevention dosage group, erythromycin （5 mg kg^-1） was injected intramuscularly in the treatment dosage group, and no treatment was given in the control group. S. suis with intermediate resistance to erythromycin was isolated on the 5th day after infection from the prevention dosage group （5th PDG） and on the 7th day after infection from the treatment dosage group （7th TDG）. Both isolates were determined to be the constitutive macrolide-lincosamide-streptogramin B （cMLSB） resistance phenotype. The resistance gene ermB was detected in all of the isolates. The results suggested that both the 5th PDG and 7th TDG isolates had a mutation （A2372T） in the 23S rRNA gene. In addition, the 5th PDG isolates had a mutation in ribosomal protein L4 （detected as G268A） and a mutation in ribosomal protein L22 （A345C）; and the 7th TDG isolates had a C insertion at site 564. Each of these mutations is considered as a possible mechanism of erythromycin resistance in S. suis strain LN. This study demonstrated that erythromycin resistance was readily induced in S. suis at a low erythromycin dose creating selective pressure in vivo. Resistance appeared to be mediated by ribosome methylation, encoded by the ermB gene.     

AcrAB Efflux Pump in Fluoroquinolone Resistant Salmonella gallinarum Induced by Ciprofloxacin Selective Pressure

Salmonella gallinarum has shown multiple drug resistance (MDR),especially high level fluoroquinolone (FQ) resistance in recent years.To determine whether the active efflux system was responsible for high-level FQ resistance,this research studied AcrAB efflux pump in Salmonella gallinarum on molecular level.The resistant strains were induced by standard strain C79-13 with ciprofloxacin in vitro.With carbonylcyanide-p-chlorophenyl hydrazone (CCCP) as an energy inhibitor,efflux inhibition test initially showed the potential impact of efflux pump on drug resistance.Sequence analysis of acrA gene indicated that gene mutation of AcrAB efflux pump was not definitely associated with MDR and drug resistance level of Salmonella gallinarum.Detected by competitive RT-PCR,the mRNA expression of acrA and acrB genes in the resistant strains significantly increased (p0.01) compared with that of the control strain C79-13.The mRNA expression level of acrB gene (increased from 1.6-to 2.9-folds) was consistent with that of acrA gene (increased from 1.6-to 2.8-folds),which increased with the drug resistance level.However,gene mutation of acrA gene showed no correlation with its mRNA expression level,indicating that gene mutation did not affect the expression of AcrAB pump itself.The results suggested that the overexpression rather than the gene mutation of AcrAB efflux pump was an important factor causing the high level drug resistance of Salmonella gallinarum.     

临床分离粪肠球菌的毒力基因和耐药基因检测及其耐药性研究

分离女性阴道中的粪肠球菌（Enterococcus faecalis）,通过PCR和Kirby-Bauer(K-B)纸片扩散法探究其毒力基因、耐药基因及其耐药表型,为揭示粪肠球菌感染机制及其临床治疗提供科学依据。结果表明：从157个样品中共分离出22株粪肠球菌;在这些粪肠球菌中：毒力基因检出率为efa A (100%)、asa1 (90.9%)、cyl A (90.9%)、fsr (90.9%)、cpd (90.9%)、acm (86.4%)、gel E (81.8%)、esp (68.2%)、ace (54.5%)和hyl (0);耐药基因的检出率为van A (0)、van B (0)、van C (18.2%)、aac (40.9%)、ant(6)-1 (59.1%)、erm B (68.2%)、mef A(54.5%)、tet M (72.2%)和tem (81.8%);药敏结果显示粪肠球菌对万古霉素、呋喃妥因、利奈唑胺、替考拉宁敏感;对其他抗菌药物具不同程度的耐药。由此得出,阴道易受粪肠球菌感染,体外实验支持糖肽类抗菌药物可用于粪肠球菌感染的临床治疗。     

海口市美兰区畜禽生鲜肉沙门氏菌分离及耐药性分析

为了解海南省海口市美兰区市售生鲜肉沙门氏菌污染情况,笔者采集了海口市美兰区市售猪肉、鸡肉和鸭肉样本共50份,进行了沙门氏菌分离、Kindy-Bauer药敏试验及耐药基因分析。结果显示:共得到4份沙门氏菌菌株,检出率为8%。4株沙门氏菌对15种抗生素产生不同耐药性,其中,对青霉素、氨苄西林、四环素和吉他霉素耐药率为100%,对氯霉素、阿莫西林和磺胺异噁唑耐药率为75%,对多西环素、红霉素、卡那霉素、诺氟沙星和链霉素耐药率达到50%。PCR结果显示,4株沙门氏菌菌株对四环素类耐药基因tetA检出率为50%,对磺胺类药物耐药基因sul2和喹诺酮类耐药基因qurB基因检出率为0。本研究结果表明,海口局部地区禽畜类生鲜肉类沙门氏菌感染率较低,但分类菌株具有较广耐药性,应加强监管。     

绍兴市售酸奶中乳酸菌的分离鉴定及耐药性分析简

[目的]从绍兴市售酸奶中分离并鉴定乳酸菌,研究乳酸菌分离株对6种抗生素的耐药性。[方法]利用MRS培养基迎过稀释法分离酸奶样品中的乳酸菌并进行菌落计数,对分离菌株进行革兰染色和生化反应鉴定,同时采用纸片扩散法进行耐药性分析。[结果]从15种绍兴市售酸奶样品中共分离出31株菌,生化反应鉴定为嗜酸乳杆菌（6株）、保加利亚乳杆菌（7株）、嗜热链球菌（11株）和双歧杆菌（7株）;活菌计数结果显示,4份样品（26．7％）中乳酸菌计数低于国家标准,11份样品（73．3％）中活菌计数符合国家标准规定;耐药性试验结果显示,31株乳酸菌对4种抗生素均有一定程度的耐受性,且90．3％的菌株具有多重耐药性,能耐受2～3种抗生素。[结论]绍兴市售酸奶中乳酸菌已具有一定程度的耐药性,对酸奶产品进行耐药性监测和安全评价已势在必行。     

Genetic characterization of antimicrobial resistance in Staphylococcus aureus isolated from bovine mastitis cases in Northwest China

Staphylococcus aureus is the most common etiological pathogen of bovine mastitis. The resistant strains make the disease difficult to cure. The aim of this study was to characterize the genetic nature of the antimicrobial resistance in S. aureus cultured from bovine mastitis in Northwest China in 2014. A total of 44 S. aureus were isolated for antimicrobial resistance and resistance-related genes. Antimicrobial resistance was determined by disc diffusion and the corresponding resistance genes were detected by PCR. Phenotype indicated that S. aureus isolates were resistant to penicillin(84.09%), erythromycin(20.45%), tetracycline(15.91%), gentamicin(9.09%), tobramycin(6.82%), kanamycin(6.82%) and methicillin(2.27%). 9.09% of the S. aureus isolates were classified as multidrug resistant. In addition, genotypes showed that the isolates were resistant to rifampicin(100%, rpo B), penicillin(95.45%, bla Z), tetracycline(22.73%, tet K, tet M, alone or in combination), erythromycin(22.73%, erm B or erm C), gentamicin/tobramycin/kanamycin(2.27%, aac A-aph D), methicillin(2.27%, mec A) and vancomycin(2.27%, van A). Resistance to tetracycline was attributed to the genes tet K and tet M(r=0.558, P 0.001). This study noted high-level geno- and phenotypic antimicrobial resistance in S. aureus isolates from bovine mastitis cases in Northwest China.     

氟苯尼考与黏菌素联用对猪大肠杆菌与链球菌的体外抗菌作用

采用棋盘法,测定了氟苯尼考与黏菌素联用对猪大肠杆菌、链球菌分离株的体外抗菌活性。结果表明:猪大肠杆菌、链球菌分离株均对氟苯尼考呈现出耐药性,其最小抑菌浓度(MIC)为0.64~5.12 mg/L,大部分大肠杆菌分离株对黏菌素耐药,仅对其中一株有明显效果。棋盘法测得氟苯尼考与黏菌素联合对猪大肠杆菌、猪链球菌分离株的部分抑菌浓度(FIC)指数为0.031 26~0.140 63,均为协同作用。当浓度大于或等于0.16 mg/L时即呈现出协同作用。