头孢哌酮/舒巴坦敏感鲍氏不动杆菌β-内酰胺酶基因研究  

β-lactamase Genes of Cefoperazone/sulbactam-sensitive Acinetobacter baumannii

作　　者：杨宏伟[1] 侯玲俐[1,2] 吕军[1] 张吉才[1] 陶建蜀[2] 陈武[3] 高波[1] 余宗涛[1] 

机构地区：[1]郧阳医学院附属太和医院检验部,湖北十堰442000 [2]贵阳医学院检验系,贵州贵阳550000 [3]广东药学院生物技术系,广东广州510006

出　　处：《中华医院感染学杂志》2010年第20期3092-3095,共4页Chinese Journal of Nosocomiology

摘　　要：目的了解十堰地区鲍氏不动杆菌的β-内酰胺酶基因存在状况,揭示多药耐药鲍氏不动杆菌的耐药机制。方法回顾性分析2009年鲍氏不动杆菌的耐药率,PCR检测20株头孢哌酮/舒巴坦敏感鲍氏不动杆菌的β-内酰胺酶基因。结果 2009年分离到鲍氏不动杆菌205株,除头孢哌酮/舒巴坦的耐药率在18.0%,黏菌素全部敏感之外,对其他抗菌药物的耐药率均约90.0%;20株头孢哌酮/舒巴坦敏感鲍氏不动杆菌通过PCR检出blaTEM、blaPER、blaVEB、blaCARB、blaGIM、blaDHA;未检出blaSHV、blaOXA、blaGES、blaSPM、blaVIM、blaIMP、oprD2基因。结论目前分离株对黏菌素全部敏感,对头孢哌酮/舒巴坦的敏感性相对较高,对其他抗菌药物的敏感性较低,多药耐药鲍氏不动杆菌携带多种β-内酰胺酶基因,临床应根据药敏结果合理使用抗菌药物。OBJECTIVE To investigate the current status of β-lactamase genes of Acinetobacter baumannii（ABA）in Shiyan territory,and to reveal drug resistance in A.baumannii strains as well as inter-strains genetic relationship,so as to disclose the drug-resistant mechanisms of ABA.METHODS ABA strains isolated from Jan to Dec 2009 were retrospectively analyzed.The antimicrobial drug susceptibility test was conducted by K-B method and the multi-drug resistance was identified according to CLSI 2007 criteria.13 molecular markers in β-lactamase gene were analyzed by PCR in 20 strains of only Cefoperazone/sulbactam-sensitive ABA.RESULTS A total of 205 strains of A.baumannii were isolated from clinical samples in 2009.The resistant rate of A.baumannii to most antibiotics was about 90.0%,except for 18.0% to cefoperazone/sulbactam,all of the rest were sensitive to colistin.Among the 20 strains of only Cefoperazone/sulbactam sensitive ABA strains,β-lactamase gene bla TEM,bla PER,bla VEB,bla CARB,GIM,bla DHA were detected,but oprD2,bla SHV,bla OXA,bla GES,bla SPM,bla VIM and bla IMP were not detected out.CONCLUSION All the isolated ABA strains are sensitive to colistin,and have high sensitivity to cefoperazone/sulbactam,the sensitivity to other antibiotics are inferior to carbapenem.The MDRAB strains carry with many β-lactamase genes.Rational application of antibiotics in clinics should be done in accordance with drug susceptibility tests.

关 键 词：医院感染 鲍氏不动杆菌 多药耐药 耐药基因 

分 类 号：R378[医药卫生—病原生物学]