鲍曼不动杆菌耐药表型及碳青霉烯酶OXA基因分析  

Analysis of Antimicrobial Resistance Patterns and Carbapenemases Gene of OXA among Acinetobacter Baumannii

作　　者：彭俊华[1] 张媛媛[1] 付藏红[1] 张峰[1] 马芳军[1] 

机构地区：[1]兰州军区兰州总医院检验科,兰州730050

出　　处：《现代检验医学杂志》2009年第5期39-42,共4页Journal of Modern Laboratory Medicine

摘　　要：目的检测鲍曼不动杆菌耐药表型及碳青霉烯酶OXA基因型。方法用VITEK32鉴定出174株不动杆菌，用K—B纸片检测抗生素的耐药性，用琼脂稀释法测定抗生素的最小抑菌浓度（MIC），用多重PCR方法测定碳青霉烯酶OXA23类，OXA24类，OXA51类和OXA58类基因。结果检出鲍曼不动杆菌146株（83．91％），耐亚胺培南的鲍曼不动杆菌46株（31．50％）。鲍曼不动杆菌呈现出多重耐药性，亚胺培南、奈替米星、左氧氟沙星、头孢吡肟和哌拉西林／他唑巴坦的敏感率分别为70．69％，48．85％，44．83％，43．68％，44．83％。亚胺培南的MIC值为16～64μg／ml；耐亚胺培南鲍曼不动杆菌OXA基因主要为OXA23类，检出率为82．61％，且以OXA23／OXA51类基因为主（60．87％），检出0XA23／OXA58类1株，未测得OXA24类。结论鲍曼不动杆菌呈现出多重耐药性，以OXA23／OXA51型碳青霉烯酶为主。Objective To investigate the antimicrobial susceptibility patterns and OXA gene of carbapenemases among Acinetobacter baurnannii. Methods 174 Acinetobacter SPP isolates were identified using VITEK32. Resistance of antibiotics was tested using Kirby-Bauer method. Minimal inhibitory concentration （MIC） of antibiotics were determined using disk agar diffusion testing. Carbapenemases of OXA23 like,OXA24 like ,OXA51 like and OXA58 like genes were detected using multiplex-PCR. Results 146 （83.91%） Acinetobacter baumannii were identified. 46（31.50%） Acinetobacter baumannii of imipenem resistance isolates were detected. The isolates of Acinetobacter baumannii showed multidrug resistance to different antibiotics. The rates of susceptibility to imipenem, netilmicin,levofloxacin, cefepime and piperacillin-tazobactam were 70. 69% ,48.85% ,44.83% ,43.68% and 44.83% ,respectively. The MIC of imipenem for the resistance isolates ranged from 16 to 64 μg/ml. The OXA23 like gene was the majority OXA gene among Acinetobacter baumannii of imipenem resistance,it was 82. 61% of the isolates. The co-existence of OXA23/OXA51 like gene was the majority gene,it was 60. 87%.1 isolated strain of co-existence of OXA23/OXA58 like gene was detected and no OXA24 like gene was detected among Acinetobacter baumannii of imipenem resistance. Conclusion Acinetobacter baumannii showed multidrug resistance. The co-existence of OXA23/OXA51 like carbapenemases gene was the majority gene among Acinetobacter baumannii of imipenem resistance.

关 键 词：鲍曼不动杆菌 碳青霉烯酶 OXA基因 药物敏感 

分 类 号：R378.99[医药卫生—病原生物学] Q933[医药卫生—基础医学]