鲍氏不动杆菌β-内酰胺酶基因的检测与分布  

Detection and distribution of β-lactmases gene in multidrug-resistant Acinetobacter baumannii

作　　者：孙运涛[1] 孙各琴[1] 张秀明[1] 张炽伦[1] 王结珍[1] 苏宇霞[1] 李美子[1] 徐全中[1] 

机构地区：[1]中山大学附属中山市人民医院检验医学中心,广东中山528400

出　　处：《中华医院感染学杂志》2011年第17期3549-3552,共4页Chinese Journal of Nosocomiology

基　　金：中山市科技计划项目(20091A034)

摘　　要：目的了解中山地区鲍氏不动杆菌β-内酰胺类药物的耐药表型和基因分布及其相关性基因型与表型的相关性。方法用VITEK-2Compact高级专家系统判定2010年1-9月分离的405株鲍氏不动杆菌对β-内酰胺类药物的耐药表型,用PCR方法检测18株多药耐药鲍氏不动杆菌的13种β-内酰胺酶基因。结果 405株鲍氏不动杆菌对β-内酰胺酶类药物的耐药表型分析:共有9种,主要表型为碳青霉烯酶+碳青霉烯类(不渗透性)占49.0%,连续分离的18株多药耐药鲍氏不动杆菌中耐药表型共有2种,表型高水平耐药+头孢菌素酶型的占16.7%,碳青霉烯酶+碳青霉烯类(不渗透性)的占83.3%;检出阳性耐药基因9种:blaTEM、blaGES、blaIMP基因阳性率均为61.1%,blaSHV66.7%,blaPER55.6%、blaOXA-10和blaVER均为5.6%,blaSPM为11.1%,oprD2基因缺失率22.2%;未检出blaCARB、blaVIM、blaGIM、blaDHA。结论临床分离的鲍氏不动杆菌β-内酰胺类药物耐药表型和基因型基本相符,推测该地区β-内酰胺类药物耐药的主要因是β-内酰胺酶基因的存在导致。OBJECTIVE To investigate the distribution and correlation of β-lactmases drug resistant phenotypes and genotypes in Acinetobacter baumannii（ABA） in zhongshan district.METHODS The senior expert system of VITEK 2 Compact was used to judge theβ-lactamase drug resistant phenotypes in 405 strains ABA from Jan 2010 to Sep 2010,and 13 kinds of β-lactamase genes were detected by PCR in the 18 strains multi-drug resistant ABA（MDR-ABA） separated continuously from Jul to Sep.RESULTS There were 9 species of β-lactamase drug-resistant phenotypes modes in 405 strains ABA：the main was carbapenemase（metallo-oroxa）＋ carbapenems（impermeability）（49.0%）;There were 2 species of β-lactamase drug-resistant phenotypes modes in 18 strains MDR-ABA separated Continuously：high level resistance ＋ cephalosporinase were accounting for 16.7%;carbapenemase（metallo-oroxa）＋ carbapenems（impermeability） were accounting for 83.3%,and 9 kinds of drug resistant genes were positive：blaTEM,blaGES and blaIMP gene were 61.1%,blaSHV 66.7%,blaPER 55.6%.blaOXA-10 and blaVER were both 5.6%.blaSPM were 11.1% and the rate of oprD2 gene deletion was 22.2%.blaCARB,blaVIM,blaGIM and blaDHA were negative.CONCLUSION The β-lactamase drug resistant phenotypes and genotypes in ABA separated from clinic are basically consistent,and presumably.The main reason that causes the aminoglycoside drug resistance is the β-lactamase gene.

关 键 词：鲍氏不动杆菌 Β-内酰胺酶 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]