多重耐药鲍曼不动杆菌的耐药分子机制及质粒谱分析  

Study on molecular mechanisms of antibiotic resistance and plasmids genotype in multi-drug resistant Acinetobacter baumannii

作　　者：张东梅[1] 徐韫健[1] 李乃健[2] 李宁[1] 余琳[1] 卢鉴财[1] 张丽梅[1] 廖伟娇[1] 

机构地区：[1]广州医学院第一附属医院检验科,广东广州510120 [2]广州医学院第一临床学院医学检验系,广东广州510120

出　　处：《热带医学杂志》2011年第9期1023-1025,1042,共4页Journal of Tropical Medicine

基　　金：广州市医药卫生科技项目(201102A213137);广州医学院第一附属医院科研基金(y200909gyfy);广州医学院青年基金项目(2010A04;2010A05)

摘　　要：目的了解我院临床分离的66株多重耐药鲍曼不动杆菌(MDRAB)的耐药性和整合子(qacE△1-sull)、转座子(tnpU)存在状况,并对菌株质粒谱进行分析。方法采用VITEK-2全自动细菌鉴定仪检测鲍曼不动杆菌对18种抗生素的药敏结果,并对该细菌进行总DNA的提取。用聚合酶链反应(PCR)检测qacE△1-sull及tnpU,提取质粒进行同源性分析。结果 66株鲍曼不动杆菌中整合子qacE△1-sull基因阳性率为31.8%,转座子tnpU基因阳性率为30.3%。携带遗传标记的菌株耐药率高,特别是对头孢曲松、氨苄西林、头孢替坦、头孢唑啉、呋喃妥因的耐药率已接近或达到100%,而对丁胺卡那霉素和头孢哌酮/舒巴坦的耐药率最低,分别为5%和20%;有19株对亚胺培南耐药,其中整合子阳性率63.2%,转座子阳性率36.8%。检出质粒的46株(70%)临床分离菌出现1～3条大质粒带,大小在1～20kb间,其中出现1条带的有33株、2条带8株、3条带5株,有12株菌提取到大小相同的质粒。结论多重耐药鲍曼不动杆菌耐亚胺培南的耐药现象严重;整合子、转座子遗传标记的携带率高,可能是鲍曼不动杆菌多重耐药的主要原因。Objective To investigate the antibiotic resistance,integron,transposon and plasmids genotype in 66 strains of multi-drug resistant Acinetobater baumannii（MDRAB） isolated from the First Affiliated Hospital of Guangzhou Medical College.Methods Resistant features to 18 kinds antibiotics were analyzed by VITEK-2 Compact.DNA was extracted from 66 strains of MDRAB and then the genetic marker of integron qacE△1-sull and transposon tnpU were amplified by polymerase chain reaction（PCR）.Plasmids were extracted for the analysis of their phylogeny.Results The results showed that the positive rate of integron qacE△1-sull is 31.8%,and the positive rate of transposon tnpU is 30.3%.The strains of carrying genetic marker have a high resistance rate,especially for Ceftriaxone,Ampicillin,Aefotetan,Cefazolin and Nitrofurantoin was approaching or reached 100%,but for Amikacin and cefoperazone-sulbactam the resistance rates were 5% and 20%,respectively.Among the 19 strains out of 66 strains with multi-drug resistance,63.2% isolates were found containing qacE△1-sull and 36.8% containing the tnpU.The positive rate of harboring plasmids in 66 strains was 70%,with a molecular weight range 1～20 kb and 1 to 3 plasmids.12 of these strains showing a plasmid DNA band of same size.Conclusion The multi-drug resistant rate of Acinetobater baumannii was high and the resistance patterns were wide.The positive rates of the integron qacE△1-sull and transposon tnpU for multi-drug resistant of Acinetobactor baumannii is high,and it was the main reason that caused Acinetobacter baumannii multi-drug resistant.

关 键 词：多重耐药 鲍曼不动杆菌 整合子 转座子 质粒 

分 类 号：R378.99[医药卫生—病原生物学]