亚胺培南耐药鲍曼不动杆菌碳青霉烯酶基因型研究  

Analysis of carbapenemase genotypes in Imipenem-resistant Acinetobacter baumannii

作　　者：宋晓萍 王静静 孙滨 王建 

机构地区：[1]山东省青岛市海慈医疗集团检验科,266033

出　　处：《国际检验医学杂志》2012年第10期1191-1192,共2页International Journal of Laboratory Medicine

摘　　要：目的对临床分离亚胺培南耐药鲍曼不动杆菌耐药性及碳青霉烯酶基因型进行研究,以指导临床合理应用抗生素。方法用琼脂稀释法检测最低抑菌浓度(MIC),聚合酶链反应(PCR)检测OXA-23、OXA-24、OXA-58、IMP和VIM碳青霉烯酶基因,并对PCR产物进行测序。结果鲍曼不动杆菌对亚胺培南耐药率为36.9%,且亚胺培南耐药组菌株对12种抗菌药物耐药率与敏感组比较,差异有统计学意义(P<0.05);在24株亚胺培南耐药鲍曼不动杆菌中21株PCR扩增出OXA-23基因,2株扩增出VIM基因,检出率分别为87.5%和8.3%,OXA-24、OXA-58、IMP基因均未检出;PCR产物测序表明与Genbank相关基因同源性为100%。结论该院亚胺培南耐药鲍不动杆菌耐药现象严重;OXA-23碳青霉烯酶基因的产生是鲍曼不动杆菌对碳青霉烯类药物耐药的重要机制之一。Objective To investigate antibiotic resistance and carbapenemases genotype in Imipenem-resistant Acinetobacter baumannii,so as to guide the rational usage of antibiotics in clinical.Methods Agar dilution method was used to determine the minimal inhibitory concentrations（MIC） of Acinetobacter baumannii,polymerase chain reaction（PCR） was used to amplify OXA-23,OXA-24,OXA-58,VIM and IMP genes,and the positive amplified products were sequenced.Results The resistant rate to Impipenem was 36.9%.The resistant rate to 12 kinds of antibiotics in resistant group was significantly higher than in sensitive group（P〈0.05）.In the 24 strains of Imipenem-resistant Acinetobacter baumannii,21 strains were detected with OXA-23 gene and 2 strains with VIM gene,the detection rates of which were 87.5% and 8.3% respectively.All strains were negative with OXA-24,OXA-58 and IMP genes.The sequenced results were absolutely homology with the corresponding genes in Genbank.Conclusion The resistance phenomenon of Imipenem-resistant Acinetobacter baumannii might be serious,and producing OXA-23 carbapenemase could be one of the important mechanisms of carbapenem-resistance in Acinetobacter baumannii in this hospital.

关 键 词：鲍氏不动杆菌 基因 碳青霉烯酶 OXA-23基因 

分 类 号：R440[医药卫生—诊断学]