多耐药鲍曼不动杆菌耐药性分析和部分耐药基因检测  

The resistant characteristic and a part of resistance genes carried of multidrug-resistant Acinetobacter baumannii

作　　者：张玲玲[1] 胡俊锋[1] 李峰[2] 张永[1] 

机构地区：[1]蚌埠医学院第一附属医院呼吸与危重症医学科,安徽省233004 [2]蚌埠医学院第一附属医院微生物室,安徽省233004

出　　处：《中华临床医师杂志（电子版）》2012年第15期116-119,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的分析皖北地区多耐药鲍曼不动杆菌(MDR-Ab)耐药率和部分耐药基因携带情况。方法用稀释法测定抗生素的最低抑菌浓度(MIC),用PCR扩增OXA-51、OXA-23和Ⅰ～Ⅲ类整合子的整合酶基因。结果 MDR-Ab对替加环素、多黏菌素E和利福平体外药敏试验耐药率较低,分别是5.56%、6.94%、16.67%。临床常用16种抗生素中除舒普深(头孢哌酮/舒巴坦)耐药率为41.67%外,其他抗生素耐药率较高。72株MDR-Ab的OXA-51、OXA-23和Ⅰ类整合酶基因的携带率分别为100.00%、84.72%和91.67%,未检出Ⅱ和Ⅲ类整合酶基因。结论 MDR-Ab耐药形势严峻,替加环素、多黏菌素E和利福平是治疗MDR-Ab感染的有效药物。MDR-Ab携带Ⅰ类整合子阳性率较高,OXA-23是导致其对碳青霉烯类抗生素耐药的机制之一。Objective To analysis the antimicrobial resistance and a part of resistance genes carried of multidrug-resistance Acinetobacter baumannii （MDR-Ab） in the hospitals of North Anhui. Methods Minimum inhibitory concentrations（MIC） were determined by the borth dilution method. Blaoxa-51-1ike, blaoxa-23-1ike genes and integrase genes of intergrons from class 1 to 3 were researched by polymerase chain reaction. Results Tigecycline, colistin and rifampin were effective againist the MDR-Ab, the resistant rates were 5.56%, 6. 94% and 16. 67%, respectively. The lowest rates of 16 kinds currently used antibiotics was cefoperazone-sulbactam （41.67%）. While, others had high resistant rates. Among the 72 strains, all possessed blaoxa-5 l-like carbapenemase gene,84. 72% （61）carried blaoxa-23-1ike carbapenemase gene and 91.67% （66）with class 1 integrase gene. Conclusions Situation of drug resistance is serious in the clinical separated MDR-Ab. Tigecycline, colistin and rifampin are effective antibiotics to cure MDR-Ab infection. A large number of them are carrying class 1 integrase gene. Blaoxa-23-1ike gene is the resistant mechanism of permitting the strains against carbapenem.

关 键 词：整合子类 鲍曼不动杆菌 多耐药 OXA-51 OXA-23 

分 类 号：R446.5[医药卫生—诊断学]