چکیده (انگلیسی):

Objective: To investigate the distribution of pathogens and drug resistance in bile and
the association between the pregnane X receptor (PXR) gene polymorphisms, traditional
Chinese medicine (TCM) syndromes and the risk of cholesterol gallstone disease (CGD).
Methods: A total of 392 samples were enrolled in this study from January 2014 to
February 2015, among which 192 patients were with CGD, and 200 samples were
healthy. Strains were isolated and susceptibility testing was the disk diffusion method
susceptibility testing. The patients were divided into hepatochlic hygropyrexia, stagnation
of liver-qi, and the accumulation of damp. The PXR gene polymorphisms were analyzed
by polymerase chain reaction-restriction fragment length polymorphism. The association
between the PXR gene polymorphisms and the risk of CGD was examined by logistic
regression analysis.
Results: A total of 192 cases were detected in 230 of bile culture pathogens, including
Gram-negative bacteria 133 (57.83%), Gram-positive bacteria 76 (33.04%), and fungi 21
(9.13%). The top five pathogens were Escherichia coli, Klebsiella pneumoniae,
Enterococcus faecalis, Candida albicans, and Enterococcus feces, of which 110 cases
was of single infection, 48 cases of mixed infection of two strains, eight cases of mixed
infection of three bacteria. Among 59 Escherichia coli, the yield extended-spectrum betalactamases
had 40 (67.80%). The hepatochlic hygropyrexia was the most TCM syndrome,
followed by stagnation of liver-qi, and the accumulation of damp was least.
Different pathogens and the rs6785049 genotypes distributed differently in cholelithiasis
patients with different TCM syndromes (P < 0.05). In hepatochlic hygropyrexia patients
the Gram-negative bacteria was most. There was significant differences between CGD
group and control group in rs6785049 (P < 0.001). Comparison with wild-type portable
GG, GA genotype increased the risk of the occurrence of gallstones (OR = 0.40, 95%CI:
0.16–0.79); likewise, carrying the GA+AA genotype also increased the risk (OR = 0.38,
95%CI: 0.19–0.81). There was no significant differences in rs2276707, rs3814055 site
polymorphic loci alleles in CGD group and control group.