肝内胆管结石中抗生素耐药基因在性别之间分布差异的初步分析

杨晨瑞; 李君剑; 张燕忠

doi:10.3969/j.issn.1001-5256.2019.05.017

肝内胆管结石中抗生素耐药基因在性别之间分布差异的初步分析

DOI: 10.3969/j.issn.1001-5256.2019.05.017

1. 山西医科大学研究生学院
2. 山西大学黄土高原研究所
3. 山西医科大学附属人民医院普通外科

基金项目:

国家自然科学基金(41271530)；

详细信息

中图分类号: R575.7
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出版历程
- 收稿日期: 2019-01-09
- 出版日期: 2019-05-20

A preliminary analysis of the sex distribution of antibiotic resistance genes in patients with intrahepatic bile duct stones

Graduate school of Shanxi Medical University

Research funding:

摘要

摘要: 目的分析肝内胆管结石抗生素耐药基因（ARG）在不同性别之间的分布,为临床合理使用抗生素提供参考。方法收集2017年10月-2018年9月山西医科大学附属人民医院收治的肝内胆总管结石患者共120例,其中男60例,女60例,对所采集标本进行细菌基因组提取,并采用实时定量PCR方法进行检测。符合正态分布的计量资料组间比较采用t检验;不符合正态分布的计量资料组间比较采用Mann-Whitney U检验。Pearson线性相关分析确定可移动基因元件（MGE）和ARG丰度之间是否具有显著相关性。结果在所有测得的ARG中,男性ARG 16种,其中sull的基因检出率最高（9. 4%）。blaCTX-M、blaTEM、blaSHV、blaampC、ampC-01、ampC/blaDHA、bla-ACC-1、blaCMY、blaGES、cfxA、aac、aacc、aadA1、strB、tetX的检出率分别为7. 6%、6. 9%、7. 3%、7. 8%、6. 2%、6. 5%、3. 9%、5. 5%、2. 4%、3. 9%、5. 6%、7. 4%、6. 8%、4. 2%、8. 6%。女性ARG 7种,其...
- 胆结石 /
- 抗生素抗药性 /
- β内酰胺抗药性 /
- 氨基糖苷类 /
- 四环素类 /
- 磺胺类 /
- 性别分布 /
- 横断面研究
Abstract: Objective To investigate the distribution of antibiotic resistance genes ( ARGs) in patients with intrahepatic bile duct stones, and to provide a theoretical basis for rational use of antibiotics in clinical practice. Methods A total of 120 patients with intrahepatic bile duct stones ( 60 male and 60 female patients) in People's Hospital Affrliated to Shanxi Medical Universiry, from October 2017 to Septemper2018 were enrolled. Bacterial genome was extracted from the collected specimens, and PCR was used for detection. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. Pearson correlation analysis was used to investigate the correlation of normally distributed continuous data. Results Off all ARGs detected, 16 were detected in male patients, among which the sull gene had the highest detection rate ( 9. 4%) ; in male patients, the detection rates of blaCTX-M, blaTEM, blaSHV, blaampC, amp C-01, amp C/blaDHA, bla-ACC-1, blaCMY, blaGES, cfxA, aac, aacc, aadA1, strB, and tetX were 7. 6%, 6. 9%, 7. 3%, 7. 8%, 6. 2%, 6. 5%, 3. 9%, 5. 5%, 2. 4%, 3. 9%, 5. 6%, 7. 4%, 6. 8%, 4. 2%, and 8. 6%, respectively. Off all ARGs detected, 7 were detected in female patients, among which the sull gene had the highest detection rate ( 24%) ; in female patients, the detection rates of blaTEM, aacc, aadD, aadA1, strB, and tetX were 11. 3%, 10. 8%, 8. 4%, 11. 9%, 23. 9%, and 9. 8%, respectively. The aadD gene was not tested in male patients, and blaCTX-M, blaSHV, blaampC, ampC-01, ampC/blaDHA, bla-ACC-1, blaCMY, blaGES, cfxA, and aac were not detected in female patients.16 S rRNA gene was significantly correlated with beta-lactam ARG and tetracycline ARG ( P < 0. 01) , aminoglycoside ARG and sulfonamide ARG ( P < 0. 05) , tnpA gene was significantly correlated with beta-lactam ARG, tetracycline ARGs and sulfonamide ARG ( P < 0. 05) , and intI gene ( P < 0. 01) . Conclusion There are abundant antibiotic resistance genes in patients with intrahepatic bile duct stones, among which the sull gene has the highest abundance. At the same time, male patients have higher abundance of genes than female patients, and female patients have low abundance of beta-lactam ARGs. Therefore, beta-lactam antibiotics should be the first choice for anti-infective therapy for female patients with intrahepatic bile duct stones, while men should use a higher dose of antibiotics or a combination of several antibiotics.
- cholelithiasis /
- antibiotic resistance /
- beta-lactam resistance /
- aminoglycosides /
- tetracyclines /
- sulfonamides /
- sex distribution /
- cross-sectional studies

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