鲍曼不动杆菌碳青霉烯酶基因型及分子流行病学研究  

Study on the carbapenemase genotype and molecular epidemiology of Acinetobacter baumannii

作　　者：裘莉佩 潘登 徐炜烽 周华[2] 魏泽庆[2] 俞云松[2] 

机构地区：[1]宁波医疗中心李惠利医院,315040 [2]浙江大学医学院附属第一医院

出　　处：《中华流行病学杂志》2007年第4期381-384,共4页Chinese Journal of Epidemiology

基　　金：国家自然科学基金资助项目（30370073）

摘　　要：目的研究宁波地区3家综合性医院临床分离亚胺培南耐药鲍曼不动杆菌的耐药性、同源性及碳青霉烯酶基因型。方法收集宁波市李惠利医院、宁波市第一人民医院、宁波市第二人民医院碳青霉烯类抗生素耐药鲍曼不动杆菌28株。琼脂稀释法和E-test法测定14种抗菌药物的最小抑菌浓度值;脉冲场凝胶电泳（PFGE）分析菌株同源性;PCR及克隆测序分析碳青霉烯酶基因型。结果28株鲍曼不动杆菌对多粘菌素E耐药率最低为4．7%,头孢哌酮/舒巴坦为87%,其余抗菌药物耐药率均高于90%耐药。PFGE分型共分为4型,以A、B两型为主。28株鲍曼不动杆菌中均产OXA-23碳青霉烯酶基因,未检测到VIM、IMP型金属酶基因。结论宁波地区碳青霉烯抗生素耐药鲍曼不动杆菌均产OXA-23型碳青霉烯酶,3家医院均有克隆播散流行。Objective To investigate antibiotic resistance, clonal relatedness and carbapenemase genotype among carbapenem-resistant Acinetobacter baurnannii collected from 3 comprehensive hospitals in Ningbo city, Zhejiang province. Methods 28 strains of carbapenem resistant Acinetobacter baurnannii were collected from Ningbo Li Hui-li Hospital, Ningbo First Hospital, and Ningbo Second Hospital. The minimum inhibitory concentrations （MIC） of these strains were examined by agar dilution and E-test method. Homology of these isolates was analyzed by pulse-field gel electrophoresis（PFGE） and Genotype of carbapenemases were analyzed by PCR and verified by DNA sequencing. Results 28 strains of Acinetobacter baurnanii were highly resistant to all of the antibiotics except polymyxin E. They were classified into 4 clones based on PFGE pattern. Clone A and B had been spreading widely. All of the 28 strains produced carbapenemases which were confirmed as OXA-23 by PCR and sequencing. Metallo-betalactamase was not detected in any of the isolates. Conclusion All of the carbapenem-resistant Acinetobacter baurnannii collected from Ningbo were producing OXA-23 carbapenemase, suggesting that the transmission of clones had occurred in the 3 hospitals.

关 键 词：鲍曼不动杆菌 脉冲场凝胶电泳 流行病学 分子 

分 类 号：R686[医药卫生—骨科学]