Application Of 16S RRNA Gene Sequencing In Bacterial Identification Of Granulomatous Mastitis And The Study On The Clinical Effect Of Compound Cortex Phellodendri Liquid Treating GM

Objective:To summarize the common pathogens of granulomatous mastitis,and to explore the value of 16S rRNA gene sequencing in bacterial identification,to clarify the bacteriostatic effect of Compound Cortex Phellodendri liquid,and to carry out clinical trials to evaluate its clinical efficacy in the treatment of granulomatous mastitis,so as to provide basis for anti infection treatment of granulomatous mastitisMethods:1.The results of bacterial culture of patients with granulomatous mastitis who had been treated in breast surgery of Affiliated Hospital of Shandong University of traditional Chinese medicine in recent 5 years were analyzed retrospectively2.From January 2019 to December 2019,the pus or tissues of patients with granulomatous mastitis were collected from the Department of breast surgery,Affiliated Hospital of Shandong University of traditional Chinese medicine.30 cases were randomly selected for bacterial culture and 16S rRNA gene sequencing,and the two bacterial identification methods were compared and analyzed.3.Corynebacterium was used to study the Bacteriostatic Experiment of Compound Cortex Phellodendri liquid4.From January 2019 to December 2019,60 patients with granulomatous mastitis who were treated in the breast surgery department of the Affiliated Hospital of Shandong University of TCM and had positive bacterial culture were included in the clinical study.According to the principle of random distribution,they were divided into two groups,30 in the experimental group and 30 in the control group.The experimental group was treated by external washing with compound Phellodendron amurense liquid and conventional treatment,while the control group was treated only by conventional treatment For 5 days In order to summarize the clinical effect of compound Phellodendron amurense liquid,statistical analysis was made on the maximum breast mass diameter,breast pain score and leukocyte value of patients with granulomatous mastitis.Results:1.In the past five years,443 cases of granulomatous mastitis were treated in the breast surgery department of the Affiliated Hospital of Shandong University of TCM,153 cases were positive for bacterial culture,and the positive rate was 34.54%.Among them,Corynebacterium was the most,87 cases,accounting for 56.86%of the total,followed by Staphylococcus aureus in 33 cases,accounting for 21.57%,Staphylococcus epidermidis in 16 cases,accounting for 10.46%,mixed bacteria in 10 cases,accounting for 6.54%,and other bacteria in 7 cases,accounting for 4.58%.2.Among the 30 samples obtained under aseptic condition,9 were positive for bacterial culture,and the bacterial detection rate was 30.00%.Among them,4 were Corynebacterium,accounting for 44.44%,2 were Staphylococcus aureus and Staphylococcus epidermidis,accounting for 22.22%,1 was mixed bacteria,accounting for 11.11%.Three cases were positive for 16S rRNA gene sequencing,all of them were Corynebacterium,the bacterial detection rate was 10.00%,and further identified as c.kroppenstedtii Corynebacterium;six cases were positive for bacterial culture but negative for 16S rRNA gene sequencing.3.The MIC value of Compound Cortex Phellodendri liquid in the experimental group and benzalkonium chloride solution in the control group to Corynebacterium was 100mg/ml,and the bacteriostatic concentration of the two groups was the same.4.29 cases(96.67%)in the test group(Compound Cortex Phellodendri liquid+routine treatment)and 24 cases(80.00%)in the control group(routine treatment)were negative from bacterial culture.The difference was statistically significant(P<0.05).From the aspect of reducing the maximum diameter of breast mass,the maximum diameter of breast mass in the experimental group(2.7±0.85cm)was significantly smaller than that in the control group(3.8±1.08cm),the difference was statistically significant(P<0.01).The pain score of the experimental group(1.87±0.68)was significantly lower than that of the control group(2.6±0.86),the difference was statistically significant(P<0.01).From the aspect of reducing the number of leukocytes,the number of leukocytes in the experimental group((7.50±1.32)x109/L)was lower than that in the control group((8.16±1.10)×109/L),the difference was statistically significant(P<0.05).The total effective rate of the experimental group was 96.67%,and that of the control group was 73.33%.The total effective rate of the experimental group was higher than that of the control group(P<0.05).Conclusion:1.The occurrence of granulomatous mastitis is related to bacterial infection,especially to Corynebacterium infection.2.In the bacterial identification of granulomatous mastitis,both common bacterial culture and 16S rRNA gene sequencing can be used for bacterial identification.The sensitivity of 16S rRNA gene sequencing is lower than that of common bacterial culture,but 16S rRNA gene sequencing can determine the genetic relationship between bacteria and above taxon,and its accuracy is higher than that of common bacterial culture.3.The Compound Cortex Phellodendri liquid has the inhibitory effect on Corynebacterium,and the inhibitory concentration is the same as benzalkonium chloride solution.4.In the clinical treatment of granulomatous mastitis,on the basis of conventional treatment,combined with the application of Compound Cortex Phellodendri liquid for external washing,it can inhibit the growth of bacteria,relieve breast pain,reduce breast mass,reduce the number of white blood cells,and achieve better clinical effect,which is worthy of clinical application.