整合子介导的鲍曼不动杆菌耐药机制研究  

Study on the resistant mechanism of Acinetobacter Baumannii related with integrons

作　　者：谢瑶瑶[1] 楼杨方[1] 谭焕腾[1] 章丹[1] 李超[1] 姜爱英[1] 

机构地区：[1]温州医学院检验医学院,浙江温州325035

出　　处：《温州医学院学报》2011年第1期13-16,20,共5页Journal of Wenzhou Medical College

基　　金：温州市科技局科研基金资助项目(20060255);温州医学院在校学生科研项目(2008050)

摘　　要：目的:了解鲍曼不动杆菌临床分离株的耐药性及整合子的携带情况。方法:收集温州医学院附属第一医院住院患者标本中分离的鲍曼不动杆菌54株,用K-B法进行耐药性表型检测,使用聚合酶链反应(PCR)及核酸克隆测序等方法分析I类整合子的携带率及其基因盒类型。结果:药敏试验结果显示,我院鲍曼不动杆菌临床分离株对单酰胺类和三、四代头孢菌素表现为高度耐药(>90%),氨基糖苷类和氟喹诺酮类抗菌药物耐药性次之(>85%),硝基呋喃类抗菌药物的耐药率最低(约为55%);有40株鲍曼不动杆菌用PCR方法扩增出I类整合子基因,扩增阳性率为74.1%,产物长度多为2 200 bp;测序结果表明在I类整合子中多携带有氨基糖苷乙酰转移酶或氨基糖苷腺苷转移酶基因,部分菌株检测出插入序列及金属β内酰胺酶基因。结论:本地区鲍曼不动杆菌流行株多携带有I类整合子,耐药机制已出现新的进化方式。Objective： To investigate the resistant mechanism of Acinetobacter baumannii and the distribution of integrons in Acinetobacter baumannii.Methods： Non-repetitive 54 clinical strains of A.baumannii were collected from the specimens of inpatient of the First Affiliated Hospital.The antimicirobial susceptibility was determined with K-B method and the integrons gene was amplified with PCR,the positive PCR products were sequenced to confirm the cassettes type and arrangement.Results： The susceptibility test demonstrated that the rate of resistance to monobactam,cephalosporins,aminoglycosides and fluoroquinolone were varied from 85% to 99%,nitrofurans had the lowest resistant rate,17%.The PCR results showed that 40 clinical strains had integron genome,the length of the products mainly were 2 200 bp.The sequencing results indicated that most of the type I integrons carried the aminoglycoside acetyltransferase genome and the aminoglycoside adenyltransferase genome,the insert sequence and the metal-β-lactamase genome were also detected in parts of these strains.Conclusions： Most of the prevalent strains of A.baumannii carry the type I integrons,the new evolutional mode of resistant mechanism developes in these strains.

关 键 词：鲍曼不动杆菌 多重耐药 I类整合子 

分 类 号：R446.5[医药卫生—诊断学]