西安地区鲍氏不动杆菌耐药程度与主动外排作用的相关性研究  

Study on correlation between antibiotics resistance and effect of efflux system in Acinetobacter baumannii in Xian

作　　者：苗毅[1] 刘原[1] 和平[1] 张毅 史红阳[1] 潘双[1] 柯蕊[1] 

机构地区：[1]西安交通大学医学院第二附属医院呼吸内科,陕西西安710004 [2]检验科,陕西西安710004

出　　处：《中华医院感染学杂志》2013年第3期492-495,共4页Chinese Journal of Nosocomiology

基　　金：陕西省科学技术研究发展计划项目(2010K16-01〔2〕)

摘　　要：目的研究西安地区鲍氏不动杆菌耐药程度与主动外排作用的相关性,明确主动外排作用是鲍氏不动杆菌多药耐药的重要原因之一。方法应用K-B法进行体外药敏试验,采用羰基氰氯苯腙(CCCP)抑制试验进行外排表型检测,观察在含20μg/mlCCCP条件下152株鲍氏不动杆菌对5种抗菌药物MIC值的变化;用PCR法检测多药耐药菌adeABC外排系统的外排基因adeB和调节基因adeR、adeS。结果 CCCP抑制试验:阿米卡星、头孢他啶、环丙沙星、亚胺培南和氯霉素为底物,分别有89、64、70、46和62株符合外排阳性的标准;PCR检测多药耐药鲍氏不动杆菌基因adeB、adeR、adeS的检出率分别为74.32%、71.62%、68.92%,敏感菌株中检出率分别为16.67%、16.67%、16.67%。结论鲍氏不动杆菌中的确存在对抗菌药物的主动外排作用,主动外排作用是鲍氏不动杆菌多药耐药的重要原因之一。OBJECTIVE To study the correlation between antibiotic resistance and effect of efflux system in Acine- tobacter baumannii in Xi＇an and define that the efflux system is the main cause of the multidrug-resistance of A. baurnannii. METHODS K-B method was used to detect drug sensitivity of all isolated strains. Carbonyl cyanide m- chlorophenyl-hydrazone （CCCP） inhibition test was performed to detect the effect of efflux system, the change of the minimum inhibitory concentrations （MICs） of 5 antimierobials against 152 isolates of A. baurnannii was observed when containing 20/μg/ml CCCP. PCR was employed to detect the efflux gene adeB and the regulating gene adeR, adeS of adeABC efflux pump system in the multidrug-resistant A. baurnannii. RESULTS CCCP inhibition test was perfonmed with amikacin, ceftazidime and ciprofloxacin, imipenem and chloramphenicol as the substrates, there were respectively 89 strains, 64 strains, 70 strains, 46 strains and 62 strains of the isolates that were positive. PCR detection result showed that the detection rates of the multidrug-resistant A. baumannii efflux gene adeB and regulating gene adeR and adeS were 74. 32%, 71. 62%, and 68. 92%, respectively, and the detection rates of the gene adeB, adeR, and adeS in the sensitive strains were 16.67%, 16.67% ,and 16.67%, respectively. CONCLUSION There is indeed the postive efflux effect to antibiotics in the A. baumannii strains , and the effect of efflux system is one of the important causes of the multidrug-reistance of A. baurnannii.

关 键 词：鲍氏不动杆菌 主动外排作用 adeB基因 adeR基因 adeS基因 

分 类 号：R378[医药卫生—病原生物学]