对下呼吸道感染鲍曼不动杆菌氨基糖苷类耐药基因检测  

Identification of aminoglycoside modifying enzymes from Acinetobacter baumannii in patients with lower respiratory tract infection

作　　者：卓启芳[1] 葛庚芝[1] 毕玲[1] 赖雁平[1] 

机构地区：[1]天津医科大学第二医院呼吸内科,天津300211

出　　处：《天津医科大学学报》2012年第3期385-387,391,共4页Journal of Tianjin Medical University

摘　　要：目的:探讨鲍曼不动杆菌对氨基糖苷类抗菌药物的耐药机制。方法:收集下呼吸道感染患者痰液中分离出的鲍曼不动杆菌共136株,采用K-B纸片法测定对13种抗菌药物的敏感性。用聚合酶链反应(PCR)方法检测耐氨基糖苷类抗菌药物的鲍曼不动杆菌的8种氨基糖苷类修饰酶基因(AME)。结果:32株耐阿米卡星和庆大霉素的鲍曼不动杆菌对多粘菌素B、替加环素、头孢哌酮/舒巴坦、米诺环素敏感率分别为93.8%、81.3%、62.5%、62.5%,对其他15种抗菌药物的耐敏感率均低于18.7%。对32株耐氨基糖苷类的鲍曼不动杆菌8种氨基糖苷酶基因扩增共获得4种氨基糖苷类修饰酶基因,分别为15株aac(3)-I、32株aac(6′)-Ib、32株aac(6′)-Ⅱ、29株ant(3″)-I。结论:对氨基糖苷类耐药的鲍曼不动杆菌93.75%为多重耐药鲍曼不动菌(MDRAB)。泛耐药鲍曼不动杆菌对多粘菌素B、替加环素、头孢哌酮/舒巴坦、米诺环素敏感性较高。氨基糖苷酶aac(3)-I、aac(6′)-Ib、aac(6′)-Ⅱ、an(t3″)-I基因广泛存在于耐氨基糖苷类的鲍曼不动杆菌中。Objective： To explore the resistante mechanism of Acinetobacter baumannii（Ab） to aminoglycoside antibiotics.Methods： Kirby-Bauer method was performed to detect the sensitivity of 13 kinds of antibiotics.Eight aminoglycosides modifying enzymes（AME） of Ab resisting to aminoglycoside antimicrobial agents were detected by polymerase chain reaction（PCR）.Results： The susceptibility rates of 32 strains Ab with amikacin-resistant and gentamicin-resistant to polymyxin B,tigecycline,cefperazone-sulbactam,Minocycline were 93.8%,81.3%,62.5%,62.5%,respectively.The susceptibility rates of 32 strains to other antibiotics were less than 18.7%.4 stains of aminoglycosides modifying enzymes were isolated from 32 strains Ab with amikacin-resistant and gentamicin-resistant,they were aac（3）-I（n=15）,aac（6′）-Ib（n=32）,aac（6′）-Ⅱ（n=32）,ant（3″）-I（n=29）.Conclusion： 93.75% of aminoglycoside-resistant Ab are multidrug-resistant Acinetobacter baumannii（MDRAB）.MDRAB are sensitivity to polymyxin B,tigecycline,cefperazone-sulbactam,minocycline.Aminoglycosides modifying enzymes gene existe widely in minoglycoside-resistant Ab in clinic.

关 键 词：鲍曼不动杆菌 氨基糖苷酶 耐药基因 下呼吸道感染 

分 类 号：R378.99[医药卫生—病原生物学]