Abstract

目的 检测鼠伤寒沙门菌(STM)对喹诺酮类药物的耐药性及耐药机制分析.方法 收集2004年7月1日至10月31日武汉地区4所医院门诊腹泻患者的可疑稀便分离培养出STM 33株;琼脂稀释法测其对喹诺酮类药物的最低抑菌浓度(MIC);抽提细菌基因组DNA,聚合酶链反应(PCR)检测喹诺酮类抗菌药物作用于STM的靶位点;REP-PCR对33株STM进行基因分型.结果 33株STM中有24株对环丙沙星产生较高耐药性(MIC 4~16μg/ml),24株耐药株中gyrA位点全都发生突变点,且双重突变占92%,parC位点发生突变率为91.6%;5株STM耐药株(MIC≥8μg/ml)parE和gyrB位点发现有碱基插入;基因分型达9种.结论 武汉地区社区内STM对喹诺酮类药物的耐药性严重,其主要机制是喹诺酮类耐药决定区(QRDR)的基因突变,特别是多个位点同时突变导致高水平耐药;提示有社区流行趋势。

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