| 王 悦,吴硕东,韩金岩,吴晓东,张 震.原发性胆管色素结石患者胆汁中大肠杆菌优势血清型的分析及各亚型产生的β-葡萄糖醛酸酶活性比较[J].,2021,(16):3049-3053 |
| 原发性胆管色素结石患者胆汁中大肠杆菌优势血清型的分析及各亚型产生的β-葡萄糖醛酸酶活性比较 |
| Analysis of Predominant Serotypes of Escherichia Coli in Bile of Patients with Primary Pigment Stone of Bile Duct and Activity Comparison of β-glucuronidase Produced by Each Subtype |
| 投稿时间：2020-12-28 修订日期：2021-01-23 |
| DOI：10.13241/j.cnki.pmb.2021.16.010 |
| 中文关键词: 原发性胆管色素结石 大肠杆菌 药敏试验 血清型 β-葡萄糖醛酸酶 |
| 英文关键词: Primary pigment stone of bile duct Escherichia coli Drug sensitivity test Serotype β-glucuronidase |
| 基金项目:辽宁省科学技术计划项目(2013225049) |
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| 中文摘要: |
| 摘要 目的：对原发性胆管色素结石患者的胆管胆汁中大肠杆菌的各个亚型产生的β-葡萄糖醛酸酶活性进行对比，进而探究导致色素结石形成的大肠杆菌优势血清型。方法：选取原发性胆管色素结石患者70例，术中无菌条件下抽取胆管胆汁行细菌培养，进行菌种鉴定及药敏试验。采用玻片凝集法鉴定胆汁中培养出的大肠杆菌的血清型，根据β-葡萄糖醛酸酶的活性与β-葡萄糖醛酸酶同底物4-硝基苯-β-D-葡萄糖苷（PNPG）反应的速率k呈正比，与反应体系的OD600值成反比，计算大肠杆菌各亚型产生的β-葡萄糖醛酸酶活性。结果：共获得胆管胆汁标本70例，61例细菌培养阳性，阳性率为87.14%。共获得菌株73株，培养结果排名第1为大肠杆菌（34.25%），药敏试验敏感度前5位的药物分别为阿米卡星、哌拉西林/他唑巴坦、培南类、替加环素、头孢哌酮/舒巴坦，耐药率前5位的药物分别是四环素、左氧氟沙星、氨苄西林、氯霉素、复方新诺明。对培养出的25株大肠杆菌进行血清型鉴定，共获得13种大肠杆菌血清型，位列前3位分别为O30、O24、O79，而O24血清型大肠杆菌其时间-吸光度值曲线斜率k值明显高于其它血清型，结合其OD600值，可得出其产生β-葡萄糖醛酸酶的活性较高。结论：原发性胆管色素结石的患者胆管胆汁中最常见细菌为大肠杆菌，血清型以O30、O24、O79为主，其中O24型血清型大肠杆菌产生β-葡萄糖醛酸酶的活性较高。 |
| 英文摘要: |
| ABSTRACT Objective: The activity of β-glucuronidase produced by Escherichia coli subtypes in bile of patients with primary pigment stone of bile duct was compared, then the predominant serotype of Escherichia coli that caused the formation of pigment stones was explored. Methods: 70 patients with primary pigment stone of bile duct were selected. Bile duct bile were extracted under aseptic condition for bacterial culture during the operation, then made identification of bacteria and drug sensitivity test. Identification of Escherichia coli serotypes in bile by slide agglutination. According to the activity of β-glucuronidase and the reaction rate k of β-glucuronidase with substrate 4-nitrobenzene-β-D-glucoside (PNPG) was in direct proportion and in inverse proportion with OD600 value of reaction system to caculated activity of β-glucuronidase produced by various subtypes of Escherichia coli. Results: A total of 70 cases of bile duct bile specimen were obtained, 61 cases were positive for bacterial culture, the positive rate was 87.14%. A total of 73 strains were obtained, the culture results ranked first for Escherichia coli (34.25%). Amikacin, piperacillin/tazobactam, penem, tegacyclin, cefoperazone/sulbactam were the top five drugs in drug sensitivity test and tetracycline, levofloxacin, ampicillin, chloramphenicol, compound xinnuoming were the top five drugs of drug resistance rates. The serotypes of 25 strains of Escherichia coli were identified, a total of 13 serotypes of Escherichia coli were obtained, the top three were O30, O24 and O79. However, the slope k value of time-absorbance curve of Escherichia coli O24 serotype was significantly higher than that of other serotypes, it could be concluded that the activity of β-glucuronidase in Escherichia coli O24 serotype was high by combined with its OD600 value. Conclusion: The most common bacteria in the bile duct bile of patients with primary pigment stone of bile duct is Escherichia coli, its serotypes are O30, O24 and O79 mainly. Among them, the O24 serotype Escherichia coli has a high activity of producing β-glucuronidase. |
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