The Analysis Of Bacteria And The Detection Of Related Resistance Genes In Peritoneal Dialysis Associated Peritonitis

ObjectiveTo detect the carrying case of resistance genes and guide clinical drug use in the bacteria comes from the peritoneal dialysis related peritonitis(PDAP). According to the relevant statistics to understand both the relevance, to guide clinical drug use.Materials and MethodsThe peritoneal dialysis fluid from PDAP patients was collected in January 2014 to October2015 admitted to the Anhui Medical University, traditional culture and drug sensitive test was inplemented, at the same time.According to the results,the training samples can be divided into two groups:gram-positive bacteria and gram-negative bacteria.4 kinds of resistant genes including vancomycin resistant genes(van A/van B/van C) and first generation cephalosporin resistant genes mec A gene were tested in gran positive coccus.Carbon penicillium ene drug-resistant genes(KPC /IMP/VIM/GIM/SIM/OXA),amino sugar resistant genes(aac(6 ’)-I ad/aac(6 ’)-I b/aac(3)-I/ant(3 ’’)-I and 16 s r-RNA),methylation gene(arm A/rmt B/rmt C), the third generations of cephalosporins drug resistant genes(SHV/TEM/CTX-M/OXA) were tested in gran negative coccus by applying multiple polymerase chain reaction. To compare the amplification results with genetic sequences in Genbank, in order to make clear genotype.Results:1. Included in the sample, a total of 54, training result as gram positive coccus of 44(81.48%), the main positive for staphylococcus aureus; Gram-negative bacillus 10(18.52%), mainly escherichia coli;2. In the 44 specimens which are Gran positive coccus, 4 contains van A genes, 37 carry van C gene, 12 carry mec A gene, no detection van B genes. The drug resistant rate of the samples with mec A gene were higher than those without mec A gene, difference was statistically significant(p < 0.05). Samples of cefazolin resistant rate were 63.63%, all of the samples were sensitive to vancomycin. In the 10 samples of gram-negative bacilli,penicillium carbon alkene and amikacin resistant genes were not detected, 8 carry SHV gene, two carry TEM gene, CTX-m and OXA gene were not detection.The drug resistant rate of the samples with resistant genes were higher than those without resistant genes,difference was not statistically significant(p > 0.05).3.Samples were gram positive coccus of cefazolin resistant rate of 63.63%, are all sensitive to vancomycin; Gram-negative bacillus samples of carbon penicillium alkene and amino glycoside antibiotics are sensitive, 3 cases with common to the third generations of cephalosporins antibiotics resistance.Conclusions:1.In our hospital, the PDAP patients was given priority to Gram positive bacteria, the sample carried resistance gene showed multidrug resistance, related resistant gene play an important role in the resistance mechanisms.2.The related resistance genes plays an important role in the drug-resistant mechanism,so the detection related resistance genes to sample had a certain guiding role on clinical drug use.