产AmpC酶鲍曼不动杆菌的耐药表型及基因型分析  

Antibiotic-resistant phenotype and genotype of AmpC β-lactamase in acinetobacter baumannii

作　　者：暴蓉[1] 赵克斌[1] 戎建荣[2] 李连青[2] 王淑峰[1] 崔巧珍[3] 李浩[1] 

机构地区：[1]山西医科大学第一医院检验科,太原030001 [2]山西省临床检验中心 [3]山西省人民医院检验科

出　　处：《中国药物与临床》2011年第7期772-774,共3页Chinese Remedies & Clinics

基　　金：山西省归国留学人员课基金(2010-14-94)

摘　　要：目的通过对鲍曼不动杆菌产AmpCβ-内酰胺酶的耐药表型及基因型分析,研究其耐药特征和流行趋势。方法收集2010年1月至10月两所综合性医院临床分离的多重耐药鲍曼不动杆菌63株,采用琼脂扩散法进行药物敏感试验,采用聚合酶链反应检测AmpC酶。结果 63株鲍曼不动杆菌耐头孢西丁61株(96.8%),而且对临床其他常用抗生素的耐药率也非常高,均在90%以上(除亚胺培南,美罗培南,米诺环素,阿米卡星,头孢哌酮/舒巴坦,替卡西林/棒酸),表现为多重耐药,其中对米诺环素的敏感率最高为56%,头孢哌酮/舒巴坦位列第二为41.3%。所测63株鲍曼不动杆菌中AmpC酶阳性率为67%。结论鲍曼不动杆菌多重耐药有蔓延趋势,出现1株对临床现有抗生素全部耐药的菌株。AmpC酶在鲍曼不动杆菌的耐药机制中起重要作用,其携带率为67%。米诺环素和头孢哌酮/舒巴坦是目前本地区最为有效的抗菌药物。Objective To study the resistance characteristics and the tendency of AmpC β-lactamase in acinetobacter baumannii by analyzing their resistant phenotype and genotype in Shanxi province.Methods Totally 63 strains of multidrug resistant acinetobacter baumannii were collected by clinical dissociation from two comprehensive hospitals of Shanxi province from January to October of 2010.Drug sensitivity test was performed by agar diffusion method.Polymerase chain reaction（PCR） was used to detect AmpC enzyme.Results Sixty-one strains out of the 63 were resistant to cefoxitin,with a resistant rate of 97%,and the resistant rates to other commonly used antibiotics were also rather high,all above 90% except for imipenem,meropenem,minocycline,amikacin,cefoperazone /sulbactam,ticarcillin /clavulanic acid.Multiple drug resistance was noted,and the sensitivity rate to minocycline was the top rate,at 56%,that to cefoperazone /sulbactam ranked the second,at 41%.AmpC enzyme positive rate was 67% in all the 63 strains of acinetobacter baumannii.Conclusion The situation of acinetobater baumannii resistance is very serious in Shanxi province,and multiple drug resistance is spreading.A strain resisting all current antibiotics is noted.AmpC enzyme plays an important role in acinetobater baumanii drug-resistant mechanism,the carrying rate of which is 67%.Minocycline and cefoperazone /sulbactam are presently the most effective antibiotics in Shanxi.

关 键 词：鲍曼不动杆菌 AMPC酶 耐药性 

分 类 号：R440[医药卫生—诊断学]