【Abstract】：ObjectiveTo investigate the distribution of antibiotic resistance genes (ARGs) in patients with intrahepatic bile duct stones, and to provide a theoretical basis for rational use of antibiotics in clinical practice. MethodsA total of 120 patients with intrahepatic bile duct stones (60 male and 60 female patients) in People′s Hospital Affrliated to Shanxi Medical Universiry, from October 2017 to Septemper 2018 were enrolled. Bacterial genome was extracted from the collected specimens, and PCR was used for detection. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. Pearson correlation analysis was used to investigate the correlation of normally distributed continuous data. ResultsOff all ARGs detected, 16 were detected in male patients, among which the sull gene had the highest detection rate (9.4%); in male patients, the detection rates of blaCTX-M, blaTEM, blaSHV, blaampC, ampC-01, ampC/blaDHA, bla-ACC-1, blaCMY, blaGES, cfxA, aac, aacc, aadA1, strB, and tetX were 7.6%, 6.9%, 7.3%, 7.8%, 6.2%, 6.5%, 3.9%, 5.5%, 24%, 3.9%, 5.6%, 7.4%, 6.8%, 4.2%, and 8.6%, respectively. Off all ARGs detected, 7 were detected in female patients, among which the sull gene had the highest detection rate (24%); in female patients, the detection rates of blaTEM, aacc, aadD, aadA1, strB, and tetX were 11.3%, 10.8%, 8.4%, 11.9%, 23.9%, and 9.8%, respectively. The aadD gene was not tested in male patients, and blaCTX-M, blaSHV, blaampC, ampC-01, ampC/blaDHA, bla-ACC-1, blaCMY, blaGES, cfxA, and aac were not detected in female patients. 16S rRNA gene was significantly correlated with beta-lactam ARG and tetracycline ARG（P＜0.01）, aminoglycoside ARG and sulfonamide ARG（P＜0.05）, tnpA gene was significantly correlated with beta-lactam ARG, tetracycline ARGs and sulfonamide ARG（P＜0.05）, and intI gene（P＜0.01）. ConclusionThere are abundant antibiotic resistance genes in patients with intrahepatic bile duct stones, among which the sull gene has the highest abundance. At the same time, male patients have higher abundance of genes than female patients, and female patients have low abundance of beta-lactam ARGs. Therefore, beta-lactam antibiotics should be the first choice for anti-infective therapy for female patients with intrahepatic bile duct stones, while men should use a higher dose of antibiotics or a combination of several antibiotics.
【Key words】：cholelithiasis； antibiotic resistance； beta-lactam resistance； aminoglycosides； tetracyclines； sulfonamides； sex distribution； cross-sectional studies