呼吸重症监护病房多重耐药鲍曼不动杆菌耐药基因研究  

Study on drug-resistant genes of multi-drug resistant Acinetobacter baumannii in respiratory intensive care unit

作　　者：阎锡新[1] 赵媛媛[1] 祁春艳[1] 张鲁涛[1] 潘文森[1] 

机构地区：[1]河北医科大学第二医院呼吸内科河北省呼吸病研究所,石家庄050000

出　　处：《国际呼吸杂志》2010年第24期1476-1479,共4页International Journal of Respiration

摘　　要：目的 观察我院呼吸重症监护病房（RICU）临床分离多重耐药鲍曼不动杆菌β-内酰胺酶基因和消毒剂耐药基因qacE△1-sul1存在状况.方法 收集RICU分离多重耐药鲍曼不动杆菌16株,采用PCR方法检测8种β-内酰胺酶基因（TEM、SHV、PER、DHA、IMP、VIM、OXA-23、OXA-24）和消毒剂耐药基因（qacE△1-sul1）共9种基因.采用多基因聚类分析方法进行多重耐药菌株亲缘性分析.结果 16株多重耐药鲍曼不动杆菌中blaOXA-23阳性5株（31.25%）,blaTEM阳性2株（12.50%）,blaDHA 2株（12.50%）,blaOXA-24 1株（6.25%）,blaPER 1株（6.25%）.blaSHV、blaIMP、blaVIM均未检出,消毒剂耐药基因检测qacE△1-sull阳性16株（100.00%）.多基因聚类分析发现存在克隆传播现象.结论 我院RICU多重耐药鲍曼不动杆菌携带多种β-内酰胺酶基因,消毒剂耐药基因携带率高,聚类分析显示存在克隆传播现象,应引起临床重视.Objective To investigate the state of β-lactamase genes and disinfectant resistance gene qacE/△ 1-sul1 in multi-drug resistant Acinetobacter baumannii clinically isolated in respiratory intensive care unit （RICU） of the hospital. Methods 16 strains of multi-drug resistant Acinetobacter baumannii were isolated from hospitalized patients in RICU. β-lactamase genes including TEM, SHV, PER, DHA,IMP,VIM, OXA-23, OXA-24 and qacE/△1-sul1 were detected by PCR. The homology of multi-drug resistant strains was investigated by polygene cluster analysis. Results In 16 strains of multi-drug resistant Acinetobacter baumannii, the positive rates of blaOXA-23, blaTEM, blaDHA, blaOXA-24,blaPER and qacE/△1-sul1 were 31.25%, 12.50%, 12.50%, 6.25%, 6.25% and 100.00%, respectively,while blaSHV, blaIMP, blaVIM were all negative. Polygene cluster analysis result showed that there was a clone propagation phenomenon. Conclusions Multi-drug resistant Acinetobacter baumannii carries various β-lactamase genes in RICU of the hospital,the positive rate of qacE/△1-sul1 is high. The cluster analysis shows that there is a clone propagation phenomenon,which should be paid attention to.

关 键 词：多重耐药 鲍曼不动杆菌 耐药基因 聚类分析 

分 类 号：R446.5[医药卫生—诊断学]