多重PCR检测心血管内科ICU患者分离耐碳青霉烯酶类鲍氏不动杆菌OXA基因研究  

Multi-PCR method in detecting OXA gene of carbepenem-resistant Acinetobacter baumanniiisolated from ICU patients in cardiovascular physician ward

作　　者：杨剑[1] 

机构地区：[1]杭州钢铁集团公司职工医院心血管内科,浙江杭州310022

出　　处：《中华医院感染学杂志》2011年第20期4202-4204,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查医院心血管内科ICU患者鲍氏不动杆菌临床分离株OXA基因的分布以及与鲍氏不动杆菌耐药谱的关系,并初步探讨其在分子流行病学分析中的作用。方法收集心血管内科ICU患者2009年1月-2010年12月分离的耐碳青霉烯类鲍氏不动杆菌50株和碳青霉烯敏感鲍氏不动杆菌,采用多重PCR对其进行OXA基因检测,统计并分析耐药组和敏感组基因型的差别,分析基因型和耐药性之间的关系。结果根据多重PCR产物片段大小分析,50株心血管内科ICU分离的耐碳青霉烯类鲍氏不动杆菌中均携带有OXA基因,其中OXA-51+OXA-58基因阳性有20株,5株仅OXA-51基因阳性,3株OXA-23基因阳性;碳青霉烯类耐药株同时携带OXA-51/OXA-58基因阳性率显著高于碳青霉烯类敏感株(t=5.97,P<0.05);但碳青霉烯类耐药株携带OXA-51基因阳性率与碳青霉烯类敏感株之间差异无统计学意义。结论医院心血管内科ICU患者鲍氏不动杆菌耐药率高,大部分携带有OXA基因,主要携带有OXA-51/OXA-58基因,且其与碳青霉烯类耐药之间存在着一定的相关性。OBJECTIVE To investigate the distribution of OXA gene and to analyze their effect on the drug resistance in Acinetobacter baumannii strains isolated from the ICU patients in Cardiovascular physician ward.METHODS A total of 50 isolates of carbepenem resistant strains and 20 isolates of carbepenem susceptible strains were isolated from the ICU patients in Cardiovascular physician ward in our hospital from Jan 2009 to Dec 2010.The genetype of OXA gene was determined by multi-PCR,to calculate the difference between the carbepnem-resistant strains and the carbepenem-susceptible strains.Analysis the relationship between the genetype and the resistance.RESULTS According to the analysis the PCR products clip size,50 carbepenem-resistant A.baumannii strains isolated from Cardiovascular physician ward all carried the OXA gene,and 20 strains carried the OXA-51/OXA-58 gene,only 5 strain carried the OXA-51 lonely,3 strains of the OXA-23 gene.The rate of the carbepenem-resistant strain joint carried the OXA-51/OXA-58 was significant higher than the carbepenem susceptible strains（t=5.97,P〈0.05）,however,there was no significant difference of the rate of OXA-51 gene between carbepnem-resistant strains and the carbepenem-susceptible strains.CONCLUSION The drug resistant rate of A.baumannii strains isolated from the ICU patients in Cardiovascular physician ward is high,most of them have the OXA gene.The main genotype is the OXA-51/OXA-58 gene,and also there is some relationship between it and the carbepenem-resistance.

关 键 词：鲍氏不动杆菌 Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]