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目的:了解临床分离铜绿假单胞菌Ⅲ型分泌系统(type Ⅲ secretion system,T3SS)毒力基因exoS、exoU的分布特征及耐药特点,为铜绿假单胞菌感染的治疗与控制提供参考。方法:收集2015年9月至2016年3月临床送检标本,分离鉴定铜绿假单胞菌,液体稀释法进行药敏试验,PCR技术检测分离菌株exoS、exoU基因,并对结果进行统计分析。结果:exoS、exoU基因检出率分别为85.71%(54/63)、65.08%(41/63)。4种基因型exoS+/exoU+、exoS+/exoU-、exoS-/exoU+和exoS-/exoU-的阳性率分别为53.97%、31.75%、11.11%和3.17%。呼吸道标本检出率最高的基因型是exoS+/exoU+(60.87%),泌尿道以exoS+/exoU-为主(57.14%)。多重耐药菌exoS、exoU阳性率为80.95%、76.19%,非多重耐药菌阳性率为88.10%、59.52%,比较无显著性差异(p>0.05)。exoS+/exoU+基因型菌株耐药率较高,对亚胺培南和左氧氟沙星耐药性明显高于其他菌株(p<0.05)。结论:临床分离铜绿假单胞菌毒力基因exoS、exoU携带率较高,以exoS+/exoU+基因型为主,基因型表达存在感染部位差异。多重耐药菌与非多重耐药菌基因表达无显著性差异,但同时携带两种毒力基因菌株耐药性强。
OBJECTIVE: To investigate the distribution and drug resistance characteristics of exoS and exoU virulence genes isolated from clinical isolates of type Ⅲ secretion system (T3SS), and to provide reference for the treatment and control of Pseudomonas aeruginosa infection. Methods: The clinical specimens were collected from September 2015 to March 2016, Pseudomonas aeruginosa was isolated and identified by drug-sensitivity test. The exoS and exoU genes were detected by PCR and the results were statistically analyzed. Results: The detection rates of exoS and exoU genes were 85.71% (54/63) and 65.08% (41/63), respectively. The positive rates of exoS + / exoU +, exoS + / exoU-, exoS- / exoU + and exoS- / exoU- of the four genotypes were 53.97%, 31.75%, 11.11% and 3.17%, respectively. The genotypes with the highest detection rate of respiratory specimens were exoS + / exoU + (60.87%) and urinary exu + exoU- (57.14%). The positive rates of exoS and exoU were 80.95% and 76.19%, respectively. The positive rates of non-multi-drug resistant bacteria were 88.10% and 59.52%, respectively. There was no significant difference (p> 0.05). The drug resistance rate of exoS + / exoU + genotype strains was higher than that of other strains (P <0.05). The drug resistance to imipenem and levofloxacin was significantly higher than that of other strains. CONCLUSION: The isolates of P. aeruginosa virulence gene exoS and exoU are highly susceptible to the genotypes of exoS + / exoU +. There was no significant difference in gene expression between multidrug-resistant and non-multi-drug resistant strains, but the strains carrying two virulence genes were highly resistant.