耐亚胺培南鲍氏不动杆菌碳青霉烯酶基因的研究  

Study on carbapenemase genotype of imipenem-resistant acinetobacter baumannii

作　　者：马红映[1] 汪丽[1] 吕婉飞[1] 舒丽华[1] 丁群力[1] 孙士芳[1] 邓在春[1] 

机构地区：[1]宁波大学医学院附属医院呼吸内科,浙江宁波315020

出　　处：《中华医院感染学杂志》2011年第24期5114-5117,共4页Chinese Journal of Nosocomiology

摘　　要：目的分析39株耐亚胺培南鲍氏不动杆菌的耐药性、碳青霉烯酶基因及插入序列、Ⅰ类整合子基因的分布情况。方法收集医院2009年6月-2010年6月分离的39株耐亚胺培南鲍氏不动杆菌;微量稀释法检测对常用抗菌药物的敏感性;PCR扩增和序列测定分析碳青霉烯酶及其插入序列、Ⅰ类整合子基因型。结果 39株鲍氏不动杆菌分离自临床12个科室,对阿米卡星、多黏菌素及米诺环素的耐药性分别为5.1%、0、0,对其余抗菌药物的耐药性>90.0%;39株blaOXA-51-like基因阳性,37株blaOXA-23-like基因阳性,经序列测定及BLAST比对,为blaOXA-66及blaOXA-23型酶;blaOXA-23位于插入序列下游34bp,blaOXA-66位于插入序列下游8bp;39株Ⅰ类整合子基因阳性;未检测到blaOXA-24-like、blaOXA-58-like型酶及blaIMP、blaVIM、blaSIM型金属酶。结论 blaOXA-23型及blaOXA-66型碳青霉烯酶是医院鲍氏不动杆菌耐亚胺培南的主要原因。OBJECTIVE To investigate the characteristics of Acinetobacter baumannii resistant to imipenem,classⅠintegron gene,the carbapenem-encoding genes and there relationship with ISAba1 element. METHODS Microdilution method was used to test the sensitivity of 39 A.baumannii resistant to imipenem isolated from our hospital from Jun 2009 to Jun 2010 against 13 kinds of antibiotics.PCR and DNA sequencing were used to identify the carbapenem resistant genes and their realationship with ISAbal and classⅠintegron gene. RESULTS Totally 39 isolates were from 12 wards,the resistance rate of Amicakin,Polymyxin and minocycline were 5.1%,0 and 0,respectively.The resistance rates of other antibiotics were more than 90.0%.Genes blaOXA-23-like and blaOXA-51-like were amplified from 37 and 39 isolates,respectively.Sequencing of blaOXA-51-like amplicons identified blaOXA-66,whereas blaOXA-23-like sequences were classical blaOXA-23.The blaOXA-23 gene was located 34 bp downstream of ISAba1 and blaOXA-66 gene was located 8bp downstream of ISAba1.All 39 isolates were positive for classⅠintegron genes and negative for genes blaOXA-24-like,blaOXA-58-like,blaIMP,blaVIM and blaSIM. CONCLUSION Genes blaOXA-23 and blaOXA-66 may be the main resistance mechanism which caused A.baumannii resistant to carbapenem in our hospital.

关 键 词：鲍氏不动杆菌 耐药性 碳青霉烯酶 

分 类 号：R378[医药卫生—病原生物学]