多药耐药鲍氏不动杆菌中发现氨基糖苷类修饰酶基因新亚型  

Identification on a New Subtype Gene of Aminoglycoside Modifying Enzyme in Multi-drug Resistant Acinetobacter baumannii

作　　者：朱健铭 姜如金[1] 吴康乐[1] 王建敏[2] 莫耘松[3] 马兆龙[4] 孔海深[5] 

机构地区：[1]杭州市余杭区中医院检验科,浙江杭州311106 [2]杭州市余杭区中医院药剂科,浙江杭州311106 [3]杭州市余杭区中医院检验科内科,浙江杭州311106 [4]杭州市余杭区中医院检验科骨伤科,浙江杭州311106 [5]浙江大学医学院附属第一医院检验科,浙江杭州310003

出　　处：《中华医院感染学杂志》2009年第18期2371-2375,共5页Chinese Journal of Nosocomiology

基　　金：杭州市余杭区重大科技项目(2008001);杭州市卫生科技计划项目(2008B0113);杭州市科技发展计划项目(20090833B35)

摘　　要：目的了解分离自浙江大学医学院附属第一医院的多药耐药鲍氏不动杆菌(MDR-ABA)氨基糖苷类修饰酶(AME)、16S rRNA甲基化酶基因存在状况及其遗传学背景。方法对2007年11月-2008年2月从住院患者中分离的62株MDR-ABA,采用聚合酶链反应及序列分析的方法检测15种氨基糖苷类修饰酶基因和6种16S rRNA甲基化酶基因。结果62株中,有5种基因aac(3)-Ⅰ、aac(6′)-Ⅰb、ant(3″)-Ⅰ、aph(3′)-Ⅰ、aph(3′)-Ⅱb阳性,阳性株数(%)分别为8株(12.9%)、22株(35.5%)、22株(35.5%)、19株(30.6%)、2株(3.2%),其余16种基因均阴性;5种氨基糖苷类修饰酶基因总阳性率为48.4%;随机抽提1株aac(6′)-Ⅰb阳性基因测序,发现与已在美国NCBI登录的不同,为新亚型,NCBI注册号为FJ503047。结论临床分离的MDR-ABA中氨基糖苷类修饰酶基因阳性率较高,存在新亚型;MDR-ABA氨基糖苷类抗菌药物耐药主要与氨基糖苷类修饰酶基因有关,在MDR-ABA中检出aph(3′)-Ⅰ、aph(3′)-Ⅱb基因为国内首次报道。OBJECTIVE To investigate the presence and genetic background of aminoglycoside modifying enzyme （AME） genes and 16S rRNA methylase genes in multi-drug resistant Acinetobacter baumannii （MDR-ABA）, which was isolated from the First Affiliated Hospital,College of Medicine, Zhejiang University. METHODS Sixty- two strains of MDR-ABA were isolated from the inpatients between Nov 2007 and Feb 2008, 15 kinds of aminoglycoside modifying enzyme genes and 6 kinds of 16S rRNA methylase genes were analyzed by PCR and verified by DNA sequencing. RESULTS In 62 strains of MDR-ABA the positive rate of genes of aac（3）-Ⅰ, aac （6＇）-Ⅰ b, ant（3″）-Ⅰ , aph（3′）-Ⅰ and aph（3＇）-Ⅱ b were 12. 9%, 35. 5%, 35. 5%, 30. 6% and 3. 2%, respectively. The 16 kinds of rest genes were all tested negative. The total positive rate of 5 kinds of aminoglyco- side modifying enzyme genes was 48. 4%. When they were undertaken nucleotide Sequence analysis, significant difference was found from the others that landed in the NCBI from the US, which identified itself as new subtype （NCBI FJ503047）. CONCLUSIONS There is a very high positive rate of aminoglycoside modifying enzyme genes in MDR-ABA isolated from inpatients, and there is the new subtype gene of aminoglycoside modifying enzyme. The aminoglycosides-resistant MDR-ABA in our hospital is mainly related to aminoglycoside modifying enzyme genes, and this is the first report of the emergence of aph（31）-Ⅰ and aph（3r）-Ⅱ b gene in MDR-ABA in China.

关 键 词：鲍氏不动杆菌 多药耐药 氨基糖苷类修饰酶 16S rRNA甲基化酶 基因 

分 类 号：R378[医药卫生—病原生物学]