幽门螺杆菌VacA基因型与耐药性相关性研究
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摘要
目的通过对临床分离的幽门螺杆菌(Helicobacter pylori,Hp)进行培养和药敏试验,结合基因检测的方法,探讨Hp的毒力基因Vac A多态性与其耐药性之间的关联。方法采集120例消化道疾病患者的胃黏膜组织,进行Hp分离培养和药敏试验,同时对Hp阳性且有抗生素耐药结果的菌株进行核酸提取,PCR检测Hp毒力基因VacA s区和m区的基因型。采用χ~2检验对Hp毒力基因的类型与其抗生素耐药性间相关性进行评价。结果 56例患者经Hp培养阳性,阳性率46.7%。其中克拉霉素耐药率达到了28.6%。s1/m2型的菌株中,克拉霉素耐药率为43.5%,而s1/m1型的菌株中,克拉霉素耐药率为18.2%,两者之间的差异有统计学意义(P<0.05)。结论 s1/m2型菌株比s1/m1型菌株更容易产生克拉霉素耐药性,Vac A基因可能与Hp对克拉霉素产生耐药性相关。
Objective To investigate the relationship between the virulence gene polymorphism of Helicobacter pylori( Hp) and its drug resistance by culturing Hp isolated from clinical and drug susceptibility test and combining with gene detection methods. Methods Gastric mucosa specimens were collected from 120 patients with digestive tract diseases. Hp was cultured and tested for antibiotic susceptibility. The nucleic acid was extracted from Hp positive strains with antibiotic resistance results and the Hp virulence gene VacA s region and m region were detected by PCR. The correction between the polymorphism of virulence genes and its drug resistance was evaluated by the χ~2 test. Results The positive rate was 46. 7% in 56 patients with Hp culture. Clarithromycin resistance rate reached 28. 6%. Clarithromycin resistance rate was 43. 5% in s1/m2 type strains,while in s1/m1 type strains,clarithromycin resistance rate was 18. 2%,the difference was statistically significant( P < 0. 05). Conclusion s1/m2 type strains are more prone to clarithromycin resistance than s1/m1 strains,and the gene polymorphism may be related to Hp resistance to clarithromycin.
Objective To investigate the relationship between the virulence gene polymorphism of Helicobacter pylori( Hp) and its drug resistance by culturing Hp isolated from clinical and drug susceptibility test and combining with gene detection methods. Methods Gastric mucosa specimens were collected from 120 patients with digestive tract diseases. Hp was cultured and tested for antibiotic susceptibility. The nucleic acid was extracted from Hp positive strains with antibiotic resistance results and the Hp virulence gene VacA s region and m region were detected by PCR. The correction between the polymorphism of virulence genes and its drug resistance was evaluated by the χ~2 test. Results The positive rate was 46. 7% in 56 patients with Hp culture. Clarithromycin resistance rate reached 28. 6%. Clarithromycin resistance rate was 43. 5% in s1/m2 type strains,while in s1/m1 type strains,clarithromycin resistance rate was 18. 2%,the difference was statistically significant( P < 0. 05). Conclusion s1/m2 type strains are more prone to clarithromycin resistance than s1/m1 strains,and the gene polymorphism may be related to Hp resistance to clarithromycin.
引文
1张万岱,胡伏莲,萧树东,等.中国自然人群幽门螺杆菌感染的流行病学调查[J].现代消化及介入诊疗,2010,15(5):265-270
2 Souod N,Kargar M,Doosti A,et al.Genetic analysis of cag A and vac A genes in Helicobacter Pylori isolates and their relationship with gastroduodenal diseases in the west of Iran[J].Iran Red Crescent Med J,2013,15(5):371-375
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4 吕凤臣,赵月霞.抗幽门螺杆菌用药史与耐药率的相关性分析[J].临床内科杂志,2006,23(2):124-125
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6 温晋锋,陈韶华,陈春晓.幽门螺杆菌对克拉霉素的耐药性与23S rRNA基因突变相关性分析[J].中国中西医结合消化杂志,2014,22(1):69-73
7 张双红,谢勇,李弼民,等.儿童幽门螺杆菌毒力基因与抗生素耐药相关性研究[J].临床儿科杂志,2017,35(1):59-62
8 张亚琼,章月桃.幽门螺杆菌的毒力因子分型及与胃肿瘤的相关性分析[J].黑龙江医学,2013,37(6):501-506
9 Atherton J C,Jr P R,Tham K T,et al.Clinical and pathological importance of heterogeneity in vac A,the vacuolating cytotoxin gene of Helicobacter pylori[J].Gastroenterology,1997,112(1):92-99
10 田一玲,蒋任举,李华平,等.幽门螺杆菌Vac A基因型与耐药性分析[J].重庆医学,2010,39(13):1649-1651
11 黄衍强,欧平,黄赞松,等.不同基因型的幽门螺杆菌耐药性分析[J].广东医学,2010,31(18):2378-2379
12 秦丹,朱莉,龙梅,等.贵阳地区儿童幽门螺杆菌临床分离菌株毒力基因cag A和vac A的表达情况以及与抗生素耐药之间的关系[J].贵州医药,2015,39(6):485-488
13 塔拉.不同耐药表型鲍曼不动杆菌毒力及蛋白质组学差异性研究[J].内蒙古医科大学,2015
14 Beceiro A,Tomás M,Bou G.Antimicrobial resistance and virulence:a successful or deleterious association in the bacterial world?[J].Clin Microbiol Rev,2013,26(2):185-230
2 Souod N,Kargar M,Doosti A,et al.Genetic analysis of cag A and vac A genes in Helicobacter Pylori isolates and their relationship with gastroduodenal diseases in the west of Iran[J].Iran Red Crescent Med J,2013,15(5):371-375
3 李彦玮,于玮,滕飞,等.北京地区2131例胃镜活检人群幽门螺杆菌感染分析[J].中国临床医学,2016,23(1):44-47
4 吕凤臣,赵月霞.抗幽门螺杆菌用药史与耐药率的相关性分析[J].临床内科杂志,2006,23(2):124-125
5 Kim JM,Kim JS,Kim N,et al.Gene mutations of 23S rRNA associated with clarithromycin resistance in Helicobacter pylori strains isolated from Korean patients[J].J Microbiol Biotechnol,2008,18(9):1584-1589
6 温晋锋,陈韶华,陈春晓.幽门螺杆菌对克拉霉素的耐药性与23S rRNA基因突变相关性分析[J].中国中西医结合消化杂志,2014,22(1):69-73
7 张双红,谢勇,李弼民,等.儿童幽门螺杆菌毒力基因与抗生素耐药相关性研究[J].临床儿科杂志,2017,35(1):59-62
8 张亚琼,章月桃.幽门螺杆菌的毒力因子分型及与胃肿瘤的相关性分析[J].黑龙江医学,2013,37(6):501-506
9 Atherton J C,Jr P R,Tham K T,et al.Clinical and pathological importance of heterogeneity in vac A,the vacuolating cytotoxin gene of Helicobacter pylori[J].Gastroenterology,1997,112(1):92-99
10 田一玲,蒋任举,李华平,等.幽门螺杆菌Vac A基因型与耐药性分析[J].重庆医学,2010,39(13):1649-1651
11 黄衍强,欧平,黄赞松,等.不同基因型的幽门螺杆菌耐药性分析[J].广东医学,2010,31(18):2378-2379
12 秦丹,朱莉,龙梅,等.贵阳地区儿童幽门螺杆菌临床分离菌株毒力基因cag A和vac A的表达情况以及与抗生素耐药之间的关系[J].贵州医药,2015,39(6):485-488
13 塔拉.不同耐药表型鲍曼不动杆菌毒力及蛋白质组学差异性研究[J].内蒙古医科大学,2015
14 Beceiro A,Tomás M,Bou G.Antimicrobial resistance and virulence:a successful or deleterious association in the bacterial world?[J].Clin Microbiol Rev,2013,26(2):185-230