耐多药鲍曼不动杆菌耐药基因检测结果的样本聚类分析  

Sample cluster analysis of resistance genes in multidrug-resistant Acinetobacter baumannii

作　　者：陈江平[1] 黄东标[1] 申屠桥民[1] 孔海深[2] 

机构地区：[1]浙江省磐安县人民医院检验科,浙江磐安322300 [2]浙江大学医学院附属第一医院传染病诊治国家重点实验室,浙江杭州310003

出　　处：《中国微生态学杂志》2013年第6期647-651,共5页Chinese Journal of Microecology

基　　金：国家"十一五"科技重大专项(2008ZX100-03-004);浙江省医药卫生科技计划一般项目(2013KYA220);金华市科技重点项目(2012-3-22)

摘　　要：目的调查一组耐药鲍曼不动杆菌菌株间的亲缘关系。方法收集2010年1月至2010年12月浙江某医院ICU患者痰液标本中分离的耐药鲍曼不动杆菌共20株,采用聚合酶链反应(PCR)的方法分析3种与耐药相关的看家基因(carO、gyrA、parC)和55种水平转移获得与β-内酰胺类、氨基糖苷类、喹诺酮类耐药相关基因以及12种接合性质粒、转座子、插入序列、整合子等可移动遗传元件遗传标记,再对检测结果作样本聚类分析。结果 20株耐药鲍曼不动杆菌共检出3种与耐药相关的看家基因carO、gyrA、parC,4种获得性β-内酰胺类耐药基因(TEM-1、ADC-30、ADC-60、OXA-23),5种获得性氨基糖苷类耐药基因[aac(3)-Ⅰ、aac(6')-Ⅰb、ant(3'')-Ⅰ、aph(3')-Ⅰ、armA],2种抗菌制剂外排泵基因(adeB、qacE△1),5种可移动遗传元件的遗传标记(intⅠ1、tnpU、tnp513、IS26、ISaba1)。样本聚类分析提示,20株耐药鲍曼不动杆菌可分为A与B二个簇,A簇群均为多耐药(MDR)株;A簇群又可分为A1(ADC-60阳性)与A2簇群(ADC-30阳性),均为克隆传播。B簇群均为泛耐药(PDR)株,除8号株外为克隆传播。结论 MDR和PDR菌株中均存在克隆传播。获得菌株之间的亲缘关系对院内感染实时监测和控制院内感染意义重大。Objective To investigate the phylogenetic relationship among a group of drug-resistant Acinetobacter baumannii（A.baumannii）.Methods From January 2010 to December 2010,20 strains of drug-resistant A.baumannii were collected from sputum samples of inpatients in ICU of a hospital in Zhejiang,China.Then,resistance genes were analyzed by PCR,including 3 kinds of housekeeping genes（carO,gyrA,parC） and 55 kinds of resistance genes acquired by horizontal transfer to beta-lactams,aminoglycosides and quinolones,as well as 12 kinds of genetic markers of conjugal plasmids,transposons,insertion sequences,and integrons.In addition,sample cluster analysis was performed.Results In the 20 strains of drug-resistant A.baumannii,3 kinds of housekeeping genes（carO,gyrA,parC）,4 kinds of acquired beta-lactam-resistant genes（TEM-1,ADC-30,ADC-60,OXA-23）,5 kinds of acquired aminoglycoside-resistant genes（aac（3）-I,aac（6′）-Ib,ant（3′′）-I,aph（3′）-I,armA）,2 kinds of drug efflux genes（adeB,qacE△1）,and 5 kinds of genetic markers of mobile genetic elements（intI1,tnpU,tnp513,IS26,ISaba1） were positive.Sample cluster analysis showed that these strains were divided into 2 clusters： cluster A（multi-drug resistant,MDR） and cluster B（Pan-drug resistant,PDR）.In addition,cluster A was divided into cluster A1（ADC-60 positive） and cluster A2（ADC-30 positive）,and they were all of clonal propagation.Cluster B was all of clonal propagation except Strain No.8.Conclusion Clonal propagation exists in MDR and PDR strains.So it＇s important to monitor and control noscomial infection in time depending on phylogenetic analysis result.

关 键 词：鲍曼不动杆菌 Β-内酰胺类 氨基糖苷类 喹诺酮类 可移动遗传元件 样本聚类分析 耐药 

分 类 号：R378[医药卫生—病原生物学]