产DHA-1型AmpC酶和TEM-1型β-内酰胺酶及携带Ⅰ类整合子的鲍氏不动杆菌  

DHA-1 Type Cephalosporinase Accompanied with TEM-1 and Class 1 Integron in Clinical Isolates of Acinetobater baumannii

作　　者：侯天文[1] 尹晓琳[2] 马翠卿[2] 徐树彬[1] 陈晶[1] 陈兴[1] 李玮[1] 白云[1] 

机构地区：[1]白求恩国际和平医院,河北石家庄050082 [2]河北医科大学,河北石家庄050017

出　　处：《中华医院感染学杂志》2006年第8期853-857,共5页Chinese Journal of Nosocomiology

基　　金：河北省科技攻关计划项目(04276184)

摘　　要：目的分析鲍氏不动杆菌临床株(编号0524)的β-内酰胺酶基因(BLA)、质粒介导耐氟喹诺酮基因(qnr)、氨基糖苷类修饰酶基因(AMEs)、消毒剂与磺胺类耐药基因(qacE△1-sul1)和Ⅰ类整合子酶基因(intⅠ1)存在情况。方法对0524株应用K-B法检测其耐药表型,应用三维试验检测其产生的β-内酰胺酶表型,应用聚合酶链反应及序列分析方法分析其BLAs、AMEs、qnr、qacE△1-sul1和intⅠ1基因类型。结果0524株鲍氏不动杆菌对第三代头孢菌素、头孢西丁、环丙沙星、阿米卡星耐药,对头孢吡肟、亚胺培南、头孢哌酮/舒巴坦敏感,产生AmpC酶,携有blaDHA-1基因,同时blaTEM-1型基因,acc(3)-Ⅰ、aac(6′)-Ⅰ、ant(3″)-;ⅠqacE△1-sull和intⅠ1均阳性,其他受试基因均阴性。结论0524号菌株产生DHA-1型AmpC酶和TEM-1型的广谱β-内酰胺酶,且携带Ⅰ类整合子、消毒剂与磺胺类耐药基因和3种氨基糖苷修饰酶基因,其耐药机制复杂。OBJECTIVE To analyze the genes of beta-lactamase （BLA）, aminoglycosides-modifying enzymes （AMEs）, resistant to disinfectants-sulfanilamide （qacE△1-sull）, class 1 integrase （int Ⅰ 1）, and the qnr gene associated with plasmid-mediated quinolone resistance in clinical isolate 0524 of Acinetobater baumannii. METHODS The bacterial susceptibility to antimicrobial agents for strain 0524 was determined by Kirby-Bauer method. Three-dimensional extract test was used to detect the β-1actamase phenotype of strain 0524. The genes of BLA, qnr, AMEs, qacE△1-sull, and int Ⅰ 1 were analyzed using PCR and verified DNA sequencing. RESULTS The strain 0524 of A. baumannii was resistant to the third-generation cephalosporins, cefoxitin, ciprofloxacin, and amikacin, susceptible to cefepime, imipenem, and cefoperazone-sulbactam. AmpC β-1actamases were positive. TEM-1, DHA-1, acc（3）- Ⅰ, aac（6′）- Ⅰ, ant（3″）- Ⅰ, qacE△1-sull and intⅠ 1 were positive. CONCLUSIONS It has complicated mechanism of drug resistance.

关 键 词：鲍氏不动杆菌 Β内酰胺酶 氨基糖苷类 喹诺酮类 消毒剂 整合子 基因 

分 类 号：R378.99[医药卫生—病原生物学]