多药耐药鲍氏不动杆菌对β-内酰胺类抗菌药物耐药机制的研究  

Study on resistant mechanism of multidrug-resistant Acinetobacter baumanniito β-lactam antibiotics

作　　者：陈月馨 张扣兴[2] 席云[3] 朱翔[2] 朱东林[3] 

机构地区：[1]深圳市第四人民医院ICU,广东深圳518033 [2]中山大学第三附属医院ICU,广东广州510630 [3]中山大学第三附属医院检验科,广东广州510630

出　　处：《中华医院感染学杂志》2012年第4期666-670,共5页Chinese Journal of Nosocomiology

摘　　要：目的了解临床分离的多药耐药鲍氏不动杆菌(MDRAB)对β-内酰胺类抗菌药物的耐药机制。方法从2009年4-8月中山大学附属第三医院住院患者中分离出20株MDRAB,用K-B法测定鲍氏不动杆菌对13种抗菌药物的敏感性,采用PCR及序列分析的方法分析28种β-内酰胺酶基因和膜孔蛋白carO基因。结果检测TEM、OXA-23群、ADC等3种β-内酰胺酶基因呈阳性,阳性率分别为100.0%、65.0%、100.0%;其余均阴性,膜孔蛋白carO基因检测均阳性。结论 MDRAB对多种β-内酰胺类抗菌药物耐药主要与产OXA-23群碳青霉烯和ADC型AmpC酶相关;产OXA-23型碳青霉烯酶是导致MDRAB对碳青霉烯类耐药的重要原因,与产金属β-内酰胺酶和膜孔蛋白缺失无关。OBJECTIVE To study the resistance mechanism of multidrug-resistant Acinetobacter baumannii（MDR-AB）to β-lactam antibiotics.METHODS Twenty MDR-AB strains were isolated from inpatients from the third affiliated hospital of Sun Yat-sen university from Apr.to Aug.2009,.Drug susceptibility testing was done to detect MDR-AB to 13 kinds of antimicrobial agents by K-B disk diffusion tests.Twenty-eight genes of β-lactamase,as well as carO gene were analyzed by PCR and verified by DNA sequencing.RESULTS The genes of TEM,OXA-23 and ADC were positive,the positive rate were 100.0%,65.0%,100.0%,respectively;the others were negative.All of MDR-AB have carO gene.CONCLUSION The mechanism of MDR-AB resistant to β-lactam antibiotics was the presence of OXA-23 carbapenemase and ADC type AmpC enzyme.OXA-23 carbapenemase plays an important role in MDR-AB resistance to carbapenem,and has nothing to do with metallo-β-lactamases and the loss of porin.

关 键 词：鲍氏不动杆菌 碳青霉烯类 Β-内酰胺酶基因 膜孔蛋白carO基因 

分 类 号：R378[医药卫生—病原生物学]