我国耐喹诺酮类嗜水气单胞菌毒力基因及耐药基因检出情况的系统评价

Systematic review on virulence genes of quinolones-resistant Aeromonas hydrophila and detection of drug-resistant genes in China

  • 摘要: 【目的】了解我国耐喹诺酮类致病性嗜水气单胞菌主要毒力基因及引起耐药基因的突变情况,为致病性嗜水气单胞菌的防治及毒力基因和耐喹诺酮类药物机制的研究提供参考依据。【方法】通过计算机检索中国知网(CNKI)数据库、万方数据库、维普(VIP)中文科技期刊数据库、读秀知识库等,检索时限均从建库至2016年4月,查找收集有关嗜水气单胞菌对喹诺酮类药物耐药机制研究及其毒力基因、致病机理的相关文献,采用Cochrane协作网发布的RevMan 5.3进行常规Meta分析,以加拿大卫生药品技术总署编写的ITC软件进行间接比较Meta分析。【结果】最终纳入31篇文献,其中有19篇检测了致病菌株的毒力基因,含457株菌株;11篇检测了致病菌株的耐药基因,共101株菌株;8篇检测了耐药菌株的耐药基因突变位点,共88株菌株。我国致病性嗜水气单胞菌毒力基因的检出率为:astA基因91.30%、altA基因80.42%、aerA基因72.77%、hlyA基因66.85%、actA基因62.13%、ahpA基因56.18%、ahaI基因53.04%。淮河以北地区主要以hlyA基因为主,检出率(67.31%)显著高于淮河以南地区(P<0.05,下同),且高于全国平均检出率;淮河以南地区主要以actA基因为主,检出率(93.59%)显著高于淮河以北地区,也高于全国平均检出率。质粒介导的耐药基因检出率为:qnrB基因50.00%、qepA基因32.00%、qnrS基因27.91%、qnrA基因6.98%、qnrC和qnrD基因未检出。 gyrA83位点单突变检出率显著高于gyrA83、parC87双位点突变检出率OR=0.49,95% CI(0.08,3.09),P=0.008。【结论】我国致病性嗜水气单胞菌的分子检测方法为:淮河以南地区以毒力基因actA和aerA为致病性强的判断标准,淮河以北地区以毒力基因hlyA和aerA为致病性强的判断标准。目前我国耐喹诺酮类嗜水气单胞菌的基因突变位点主要是gyrA83单位点突变和gyrA83、parC87双位点突变。

     

    Abstract: ObjectiveThe detection situation of main virulence genes in quinolones-resistant pathogenic Aeromonas hydrophila and resulting mutation of drug-resistant gene and in China, in order to provide reference for study on control of A. hydrophila and its virulence genes and quinolone-resistant molecular mechanisms. MethodThe reports on quinolones-re sistant molecular mechanisms, virulence genes and pathogenesis of A. hydrophila was collected by computer-based online search of CNKI, WANFANG DATA, VIP in Chinese science and technology periodical database and Duxiu Knowledge Base(from set-ting-up database to April 2016). Then Meta analysis was performed by Review Manager 5.3 published by Cochrane Collabora-tion network, and indirect comparative Meta analysis was performed by ITC published by Canadian Health Pharmaceutical Technology Agency. ResultA total of 31 literatures were included, 19 of which detected virulence genes of pathogenic strains (457 strains), 11 of which detected drug-resistant genes of pathogenic strains(101 strains), 811 of which detected mutational site of drug-resistant gene in drug-resistant strains(88 strains). The detection rates of virulence genes of pathogenic A. hy-drophila in China were as follows: astA 91.30%, altA 80.42%, aerA 72.77%, hlyA 66.85%, actA 62.13%, ahpA 56.18%, ahaI 53.04%. North of the Huaihe River was dominated by hlyA gene, with detection rates of 67.31%, and significantly higher than the south of Huaihe River(P<0.05, the same below), and higher than the national average detection rate. South of the Huaihe Riv-er was dominated by actA gene, with detection rate of 93.59%, and significantly higher than north of the Huaihe River area, and higher than the national average detection rate too. The detection rates of plasmid-mediated drug-resistant genes of pathogenic A. hydrophila in China were as follows: qnrB 50.00%, qepA 32.00%, qnrS 27.91%, qnrA 6.98%, but qnrC and qnrD were undetected. The detection rate of single site mutation of gyrA83 site was significantly higher than that of double sites mutations of gyrA83 and parC87OR=0.49, 95% CI(0.08, 3.09), P=0.008. ConclusionThe detection method of pathogenic A. hydrophila in China: actA and aerA are taken as judgment standard of strong pathogenicity in south of the Huaihe River; hlyA and aerA are taken as judgment standard of strong pathogenicity in north of the Huaihe River. At present, mutational site of gene is mainly gyrA83 single site mutation and gyrA83, parC87 double sites mutations in quinolones-resistant A. hydrophila in China.

     

/

返回文章
返回