| Abstract: | 困難梭狀芽孢桿菌(Clostridium difficile)簡稱 CD 菌，革蘭氏陽細菌厭氧型，擁有產孢子特性，因此其可以在險惡環境生存、潛伏。困難梭狀芽孢桿菌可經由口腔感染，一般感染後不會有太多症狀，因為腸道內的益生菌會抑制其生長。隨著年紀增長，器官老化或長期服用抗生素，困難梭狀芽孢桿菌感染就會是一個嚴重的問題。困難梭狀芽孢桿菌引發的症狀會出現發燒、噁心、疲倦、食慾不振、腹部不適、腸絞痛、黏液血便，這些臨床表徵經常會有輕度到中度的腹瀉以及嚴重的猛爆性偽膜性大腸炎，更嚴重時會出現腸阻塞及毒性巨結腸症，少數會出現非腸胃型的症狀，像是菌血症及關節炎，最後可能引發敗血症，進而死亡。本實驗探討分析的是，困難梭狀芽孢桿菌在面對那些抗生素時是會具有抵抗性以及具有那些抗藥基因，進而建議用藥安全。本實驗使用來自中國醫藥大學附屬醫院檢驗醫學部所收集到並鑑定的 127 株困難梭狀芽孢桿菌的臨床菌株，並進行抗生素敏感試驗和抗藥基因分析。在實驗結果中發現，這些所收集到的臨床菌株在藥物紙錠敏感試驗中，分別對萬古黴素，莫西沙星，四環素，紅黴素，克林黴素，氯黴素，頭孢美唑，頭孢西丁，甲硝唑，青黴素和氨芐西林-舒巴坦都具有潛在的抗藥性。而於瓊脂擴散試驗中的結果，對於頭孢美唑，頭孢西丁，氯黴素，克林黴素，青黴素和氨芐西林舒巴坦等都具有 100％的抗藥性，而其該臨床菌株的抗藥性陽性率高達 91％。以上的發現，表明這些分離株對許多抗生素具有顯著的高水平抗藥性，並且具有很高的抗藥陽性率。這項研究將提供更多的信息，對於控制該分離菌株抗生素耐藥性的傳播和出現，已是目前相當重要的策略。
Clostridium difficile is abbreviated as CD bacteria. Gram-positive bacteria are anaerobic and possess spore-producing properties, so they can survive and hide in dangerous environments. The CD strains are infected through the oral cavity. Generally, there are not too many symptoms after infection, because the probiotics in the intestine can inhibit its growth. As we grow older, organs age or take antibiotics for a long time, CD microorganism infection can become a serious problem.Symptoms caused by Clostridium difficile would have been fever, nausea,fatigue, loss of appetite, abdominal discomfort, intestinal cramps, mucus and bloody stools. These clinical signs often have mild to moderate diarrhea and severe explosive pseudomembranous colitis. In more severe cases that intestinal obstruction and toxic Hirschsprung's disease mayoccur. A few cases may have non-gastrointestinal symptoms such as arthritis, bacteremia and eventually may cause sepsis and death.This study explores that Clostridium difficile is resistant to those antibiotics, and it is recommended to use drugs safely. 125 clinical strains of Clostridium difficile were collected and identified from the university hospital medical laboratory bacterial repository of China Medical University. These isolates were detected for the antimicrobial susceptibility test and antibiotic resistance genes.The results of study that it was found that the antimicrobial susceptibility test was for vancomycin,moxifloxacin, tetracycline, erythromycin, clindamycin, chloramphenicol,cefmetazole, cefoxitin, metronidazole, penicillin and ampicillin have potential drug resistance by disk diffusion method. On the other hand, the agar diffusion test is that cefmetazole, cefoxitin, chloramphenicol,clindamycin, penicillin and ampicillin and sulbactam are 100% resistant.The positive rate of antibiotic resistance for Clostridium difficile is as high as 91%.The above findings indicate that these isolates have asignificant high level of resistance to many antibiotics and have a highpositive rate of drug resistance. This study will provide more information,which must be an important strategy to control the spread and emergenceof antibiotic resistance of Clostridium difficile isolates. |
