耐亚胺培南鲍氏不动杆菌碳青霉烯酶基因分析  

Carbapenemase genes in imipenem-resistant Acinetobacter baumannii

作　　者：梁道斌[1] 玉艳红[1] 覃金爱[1] 郭世辉[1] 

机构地区：[1]广西医科大学第一附属医院感染性疾病科,广西南宁530021

出　　处：《中华医院感染学杂志》2013年第7期1481-1483,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析医院耐亚胺培南鲍氏不动杆菌(IRAB)的碳青霉烯酶基因型和基因周围环境,为临床用药及医院感染的预防控制提供理论基础。方法采用VITEK-2药敏分析系统进行药敏试验,用改良Hodge试验和组合纸片法分别检测碳青霉烯酶和金属酶表型,PCR检测KPC、OXA-23组、OXA-24组、OXA-51组、OXA-58组基因及插入序列ISAba1。结果 36株IRAB改良Hodge阳性率33.3%;未检测到金属酶;36株均携带OXA基因,其中32株OXA-23+OXA-66阳性,2株仅OXA-66阳性,1株仅OXA-23阳性,1株仅OXA-58阳性;所有OXA-23上游均存在ISAba1,未检出KPC、OXA-24组基因。结论该院IRAB主要携带OXA-23、OXA-66型碳青霉烯酶,OXA-23与ISAba1关系密切,存在OXA-58阳性鲍氏不动杆菌。OBJECTIVE To investigate the genotypes of carbapenemase genes in the imipenem-resistant Acinetobact- er baumannii （IRA.B） and the genetic surroundings so as to provide theoretical basis for the clinical medication and the prevention and control of nosocomial infections. METHODS The antimicrohial susceptibility testing was performed by VITEK-1I analytical system. The phenotypes of carbapenemase and metalloenzyme were screened by modified Hodge test and imipenem-EDTA double-disk synergy test, respectively. The genes including KPC, OXA-23-like, OXA-24-like, OXA-51-like, OXA-58-like and insertion sequence ISAbal were detected by PCR. RESULTS Of 36 strains of IRAB tested, the positive rate of modified Hodge test was 33. 3%, and no metalloenzyme was detected. All 36 strains of IRAB possessed OXA gene, in which 32 strains carried both OXA- 23 and OXA- 66,2 strains only carried OXA- 66,1 strain carried OXA- 23, and 1 carried OXA- 58. ISAbal was found in the upstream oF all OXA-23 genes; no KPC or OXA-24-like genes were found. CONCLUSION Most isolates of IRAB have been found possessing OXA-23 and OXA-66 genes encoding carbapenemase in this hospital. ISAbal is closely correlated with OXA-23 gene. OXA-58 gene has been detected in the A. baumannii isolates.

关 键 词：鲍氏不动杆菌 碳青霉烯酶 金属酶 亚胺培南 插入序列 

分 类 号：R378[医药卫生—病原生物学]