| Objective: By analyzing high-level aminoglycoside antibiotics resistant enterococcus(HLAR)in our hospital the clinical distribution characteristics,various HLAR enterococcus epidemic situation and situation of antibiotic resistance during the year of 2014,and to test the three common modification enzyme gene,gene is calculated in the detection rate of enterococcus,To provide our clinical work out plans for the prevention and treatment of enterococcus infection and carry out the research based on the molecular level.Methods: Collect between January 2014 and December 2014,from the first hospital affiliated to dalian medical university clinical between each department makes specimens in the patients with isolated pathogenic bacteria,according to the results of clinical drug susceptibility screening HLAR strains and using-80℃ low freezing method.Using the hospital clinical laboratory in the beauty of the LIS system microbial statistical software and WHONET 5.6 software to detect the clinical HLAR bacteria distribution and resistance to various antibiotics were analyzed.Take out low-temperature preservation of species,after the recovery of bacteria with lysozyme can destroy the cell wall,use extraction kit to extract the bacterial genome HLAR enterococcus in genetic material DNA,using the polymerase chain reaction and agarose gel electrophoresis method to detect three common aminoglycoside modifying enzyme gene: aac(6 ’)/aph(2 "),aph(3 ’)2 Ⅲ and ant(6).Test results using Spss17.0 statistical software for analysis.Results: From our hospital clinical isolated 171 strains of pathogenic bacteria(no repetitive strain)in 2014,including 64 strains of excrement enterococcus,33 dung enterococcus strains,1 strain of the bird enterococcus,perseverance,enterococcus,1 strain 1 chicken enterococcus strains,1 strain of enterococcus cottonseed sugar.Detected 101 strains HLAR enterococcus distributed in multiple clinical departments,but severe strains isolated medicine obviously more than other departments,and from the point of view of specimen source,most strains isolated from urine specimens,followed by blood specimens,in addition,a variety of bile secretion specimens and part of general surgery and medical patients,ascites and pus specimens were also detected in HLAR enterococcus.Analysis of 101 strains HLAR enterococcus resistant properties found: different kinds of enterococcus differences between its resistant properties.Excrement enterococcus for test of the highest detection rate of enterococcus,in its drug resistance situation is most serious,the erythromycin resistant rate is as high as 95.31%,while to ciprofloxacin,ofloxacin and ampicillin and other commonly used antibiotic resistant rate were greater than 90%.For the above four kinds of antibiotics,muck is obviously better than the drug resistance of enterococcus excrement enterococcus,but its to tetracycline and quetiapine leptin/dafoe leptin showed highly resistant.Two kinds of enterococcus irologic resistance to commonly used several kinds of antibiotics are obviously different,the chi square test its difference is statistically significant,P < 0.05.Experiments of 101 strains HLAR enterococcus of rina thiazole amine and of supporting both antibiotics are characterized by highly sensitive,but detect enterococcus strains resistant to vancomycin,three were excrement enterococcus.Excrement enterococcus aac(6 ’)/aph(2 "),aph(3 ’)2 Ⅲ,ant(6)three kinds of drug resistance gene detection rate were 87.50%,37.5% and 40.6%.Three genes in enterococcus detection rate were 81.82%,24.24% and 27.27%,bird enterococcus and other three kinds of resistant enterococcus gene detection rate of 0.00%.Of the 101 strains,aac(6 ’)/aph(2)gene has the highest detection rate.In addition to the excrement enterococcus and other kinds of enterococcus in enterococcus did not detect the resistance genes,the experiment also not detected at the same time has three kinds of enterococcus resistant genes.Conclusion HLAR enterococcus infection rate is higher in the ICU ward and more invasive operation more department sources.Different kinds of enterococcus resistant properties,excrement enterococcus for our major epidemic of enterococcus species,its worst resistance.Aac(6 ’)/aph(2)gene detection rate is the highest,which is the main genotype caused HLAR enterococcus in Dalian. |
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