耐亚胺培南鲍曼不动杆菌耐药机制研究  

Mechanism of imipenem-resistance in Acinetobacter baumannii

作　　者：方平[1] 潘晓龙[1] 周东升[1] 吴祥林[1] 

机构地区：[1]安徽省铜陵市人民医院,铜陵244000

出　　处：《中国抗生素杂志》2007年第4期245-248,共4页Chinese Journal of Antibiotics

基　　金：安徽省卫生厅自然科研课题(No.2002A012)

摘　　要：目的研究鲍曼不动杆菌对亚胺培南的耐药机制。方法对临床分离的3株耐亚胺培南的鲍曼不动杆菌,采用KB纸片扩散法(CLSI/NCCLS2004年标准)进行药敏试验,三维试验检测ESBLs和AmpC酶,PCR方法检测TEM、SHV、PER、VEB、AmpC、IMP、VIM、OXA-23和OXA-24等9种耐药基因型,PCR阳性产物进行基因测序,结果在GenBank基因库中比对分析。结果3株鲍曼不动杆菌为多重耐药菌株,三维试验均产生ESBLs,1株产生AmpC酶,耐药基因型检测3株TEM阳性,2株PER阳性,2株AmpC酶阳性及SHV、VEB和IMP、VIM、OXA-24型等均为阴性;3株OXA-23型均阳性;另外27株对亚胺培南敏感鲍曼不动杆菌IMP、VIM、OXA-23和OXA-24型检测结果均阴性。结论耐亚胺培南鲍曼不动杆菌携带TEM、PER、非诱导AmpC酶、OXA-23型碳青霉烯酶基因,产生OXA-23型碳青霉烯酶是主要耐药机制。Objective To study the mechanism of imipenem-resistance in Acinetobacter baumannii. Methods Antimicrobial susceptibility test was done on 3 strains of Acinetobacter baurnannii isolated in Tongling by Kirby-Bauer method. Results were assessed according to the standands recommended by CLSI/ NCCLS （2004）. The detection of ESBLs and AmpC β-1actamases was performed by three-dimensional test, the genotype of TEM, SHV, PER, VEB, AmpC, IMP, VIM, OXA-23, OXA-24, and the detection and sequence analysis was performed by polymerase chain reaction （PCR）. Results Three strains in Acinetobacter baurnannil were multi-drug resistant. Three strains of imipenem-resistance were positive for blaTEM gene, 2 strains had blaPER gene, and 2 had ampC gene, OXA-23 type gene were detected in these three isolates, but no SHV, VEB, IMP, VIM and OXA-24 type gene was detected. Twenty-seven strains of imipenem-susceptibility in Acinetobacter baumannii were negative for IMP, VIM, OXA-23 and OXA-24. Conclusions Acinetobacter baumannii carried TEM, PER, AmpC and OXA-23 type gene, production of OXA-23 carbapenemase in Acinetobacter baurnannii was one of the main mechanisms of imipenem resistance the Tongling People＇s hospital.

关 键 词：鲍曼不动杆菌 OXA-23型碳青霉烯酶 耐药基因型 

分 类 号：R378.99[医药卫生—病原生物学]