多药耐药鲍氏不动杆菌β-内酰胺酶基因及膜孔蛋白基因研究  

Investigation of β-lactamase genes and outer membrane porin gene in multidrug-resistant Acinetobacter baumannii

作　　者：姜如金[1] 朱健铭 吴康乐[1] 

机构地区：[1]杭州市余杭区中医院检验科,浙江杭州311106

出　　处：《中华医院感染学杂志》2012年第3期445-448,共4页Chinese Journal of Nosocomiology

基　　金：杭州市卫生科技计划项目(2009B053);杭州市余杭区重大科技项目(2009001)

摘　　要：目的了解多药耐药鲍氏不动杆菌中β-内酰胺酶基因及膜孔蛋白基因的存在与变异情况。方法收集杭州市余杭区中医院2008年11月-2009年12月住院患者送检标本中分离的鲍氏不动杆菌共30株,先用改良三维试验同时检测头孢菌素酶(AmpC)、超广谱β-内酰胺酶(ESBLs)和金属β-内酰胺酶(MBL)3类β-内酰胺酶活性,再用聚合酶链反应的方法分析24种β-内酰胺酶基因与膜孔蛋白carO基因。结果 30株多药耐药鲍氏不动杆菌共检出TEM、ADC、OXA-23群等3种β-内酰胺酶基因,阳性率分别为100.0%、60.0%、80.0%,30号株ADC基因为新亚型;膜孔蛋白carO基因突变率达100.0%。结论鲍氏不动杆菌对多种β-内酰胺类药物耐药与产TEM、ADC、OXA-23群等3种β-内酰胺酶基因相关外,还与膜孔蛋白编码基因carO突变有关。OBJECTIVE To investigate the distribution and variation of β-lactamase genes,and outer membrane porin gene in multidrug-resistant Acinetobacter baumannii. METHODS From Nov 2008 to Dec 2009,30 strains of A.baumannii isolated from inpatients were collected from Hangzhou Yuhang Hospital of Traditional Chinese Medicine.Then,three-dimensional modified test was performed to detect activities of cephalosporinase（AmpC）,extended spectrum beta-lactamases（ESBLs） and metallo-beta-lactamases（MBL）.Furthermore,24 kinds of β-lactamase genes and outer membrane porin gene carO were analyzed by PCR. RESULTS In 30 strains of A.baumannii,3 kinds of acquired β-lactam-resistance genes TEM,ADC,OXA-23 were detected,with the positive rates of 100.0%,60.0%,80.0% respectively.and ADC gene in Strain NO.30 was a new subtype.All outer membrane porin gene carO had mutations（100.0%）. CONCLUSION In this group of A.baumannii,3 kinds of β-lactamase genes,TEM,ADC,OXA-23,and outer membrane porin carO gene might play a role in its resistance to β-lactam antimicrobial agents.

关 键 词：鲍氏不动杆菌 Β-内酰胺酶基因 膜孔蛋白 carO基因 多药耐药 变异 

分 类 号：R378[医药卫生—病原生物学]