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
计量
- 文章访问数: 980
- HTML全文浏览量: 12
- PDF下载量: 305
- 被引次数: 0
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

HTML全文

参考文献(24)

[1] HE XD, LIU QF. Diagnosis advances in surgical treatment of hepatolithiasis[J]. Chin J Dig Surg, 2015, 14 (4) :275-279. (in Chinese) 何小东, 刘乔飞.肝胆管结石病的诊断与治疗[J].中华消化外科杂志, 2015, 14 (4) :275-279.

[2] LYU WP. Clinical classification of hepatolithiasis and choice of surgical strategy[J]. J Clin Hepatol, 2013, 29 (6) :404-406. (in Chinese) 吕文平.肝胆管结石病的临床分型与手术方式选择[J].临床肝胆病杂志, 2013, 29 (6) :404-406.

[3] TSUI WM, CHAN YK, WONG CT, et al. Hepatolithiasis and the syn-drome of recurrent pyogenic cholangitis:Clinical, radiologic, and pathologic features[J]. Semin Liver Dis, 2011, 31 (1) :33-48.

[4] LI C, WEN T. Surgical management of hepatolithiasis:A mini review[J]. Intractable Rare Dis Res, 2017, 6 (2) :102-105.

[5] HE JF, TANG Y, ZHANG J, et al. Individualized treatment of intrahepatic stone for an analysis of 50 cases[J]. Chongqing Med, 2011, 40 (2) :147-148. (in Chinese) 何建峰, 唐勇, 张靖, 等. 50例肝内胆管结石个体化治疗分析[J].重庆医学, 2011, 40 (2) :147-148.

[6] YIN XY. The values and status of hepatectomy in the treatment of hepatolithiasis[J]. Chin J Pract Surg, 2016, 36 (3) :278-280. (in Chinese) 殷晓煜.肝切除在肝胆管结石治疗中的作用及地位[J].中国实用外科杂志, 2016, 36 (3) :278-280.

[7] DENG W, HAN W, PEI PC, et al. Risk factors of postoperative infection in patients with intrahepatic bile duct stones[J]. Chin J Nosocomiol, 2016, 26 (19) :4479-4481. (in Chinese) 邓伟, 韩伟, 裴鹏昌, 等.肝内胆管结石患者术后感染的相关因素分析[J].中华医院感染学杂志, 2016, 26 (19) :4479-4481.

[8] LI QL, HU CB, HU JF, et al. Risk factors for surgical incision infections in patients with hepatolithiasis[J]. Chin J Nosocomiol, 2016, 26 (9) :2059-2060. (in Chinese) 李乔林, 胡从兵, 胡剑飞, 等.肝内胆管结石手术切口感染的危险因素分析[J].中华医院感染学杂志, 2016, 26 (9) :2059-2060.

[9] DAVIES J, DAVIES D. Origins and evolution of antibiotic resistance[J]. Microbiologia, 2010, 74 (3) :417-433.

[10] ASH RJ, IVERSON JL. Antibiotic and disinfectant resistant bacteria in rivers of the united states[J]. 2004

[11] GOGARTEN JP, TOWNSEND JP. Horizontal gene transfer, genome innovation and evolution[J]. Nat Rev Microbiol, 2005, 3 (9) :679-687.

[12] ZHANG WR, NA GS, LU ZH, et al. Distribution of sulfonamides and sulfonamide-resistant Escherichia coli in the coastal marine environment of northern Yellow Sea, China[J]. Chin J Appl Environ Biol, 2014, 20 (3) :401-406. (in Chinese) 张婉茹, 那广水, 陆紫皓, 等.北黄海近岸海域磺胺类抗生素及其抗性Escherichia col分布[J].应用与环境生物学报, 2014, 20 (3) :401-406.

[13] QIAO O, HU P, JIN Y. Hepatic lobectomy and segmental resection of liver for hepatolithiasis[J]. West Indian Med J, 2014, 63 (2) :176-178.

[14] ZHANG FH, PENG HP, WANG BZ, et al. Infectious complications after hepatectomy for hepatic cancer:Analysis of risk factors[J]. Chin J Gen Surg, 2015, 24 (1) :133-135. (in Chinese) 张风华, 彭和平, 王宝枝, 等.肝癌肝切除术后感染性并发症的危险因素分析[J].中国普通外科杂志, 2015, 24 (1) :133-135.

[15] FU SJ, LI SQ, LIANG LJ, et al. Risk factors of postoperative morbidity after hepatectomy for intrahepatic stones[J]. Chin J Hepato biliary Surg, 2010, 16 (5) :325-327.

[16] WANG XW, ZHAO ZG. Risk factors for infectious complications after hepatectomy in patients with intrahepatic bile duct stones[J]. J Clin Hepatol, 2017, 33 (9) :1754-1757. (in Chinese) 王新玮, 赵宗刚.肝内胆管结石患者肝切除术后感染性并发症发生的影响因素分析[J].临床肝胆病杂志, 2017, 33 (9) :1754-1757.

[17] ERICKSON MC, LIAO J, BOYHAN G, et al. Fate of manureborne pathogen surrogates in static composting piles of chicken litter and peanut hulls[J]. Bioresour Technol, 2010, 101 (3) :1014-1020.

[18] QIAN X, SUN W, GU J, et al. Reducing antibiotic resistance genes, integrons, and pathogensin dairy manure by continuous thermophilic composting[J]. Bioresour Technol, 2016, 220:425-432.

[19] SU CY, ZHENG P, RUAN QH, et al. Efficiency of aerobic co-composting of urban sludge and Chinese medicinal herbal residues[J]. J Environ Sci, 2016, 3 (10) :4062-4068. (in Chinese) 宿程远, 郑鹏, 阮祁华, 等.中药渣与城市污泥好氧共堆肥的效能[J].环境科学, 2016, 3 (10) :4062-4068.

[20] XUE MH, HANG WH, XIU ZS, et al. Impacts of reclaimed water irrigation on soil antibiotic resistome in urban parks of Victoria, Australia[J]. Environ Pollut, 2016, 211:48-57.

[21] HU HW, WANG JT, LI J, et al. Field-based evidence for copper contamination induced changes of antibiotic resistance in agricultural soils[J]. Environ Microbiol, 2016, 18 (11) :3896-3909

[22] HEUER H, SMALLA K. Manure and sulfadiazine synergistically increased bacterial antibiotic resistance in soil over at least two months[J]. Environ Microbiol, 2007, 9 (3) :657-666.

[23] GILLINGS MR, KRISHNAN S, WORDEN PJ, et al. Recovery of diverse genes for class 1 integron-integrases from environmental DNA samples[J]. FEMS Microbiol Lett, 2008, 287 (1) :56-62.

[24] FORSBERG KJ, PATEL S, GIBSON MK. et al. Bacterial phylogeny structures soil resistomes across habitats[J]. Nature, 2014, 509 (7502) :612-630.

施引文献

资源附件(0)

访问统计