鲍氏不动杆菌耐药性分析及生物膜形成与Ⅰ类整合酶基因研究  

Drug resistance and biofilm related genes and Ⅰ class integrase gene in Acinetobacter baumannii

作　　者：董荣[1] 胡丹[1] 辛婷婷[2] 曲彦[1] 关纯[1] 

机构地区：[1]青岛大学医学院附属青岛市立医院东院重症医学科,山东青岛266071 [2]临沂市人民医院重症医学科,山东临沂276000

出　　处：《中华医院感染学杂志》2013年第13期3044-3047,共4页Chinese Journal of Nosocomiology

基　　金：山东省青岛市市南区基金项目(2011-5-013-YY)

摘　　要：目的了解青岛市ICU鲍氏不动杆菌耐药性与分布,以指导临床合理用药;了解鲍氏不动杆菌生物膜形成及Ⅰ类整合酶基因(intⅠ1)的存在情况,研究其与鲍氏不动杆菌耐药性之间的关系,探讨鲍氏不动杆菌生物膜耐药机制。方法测定477株鲍氏不动杆菌对抗菌药物的敏感性,应用PCR方法检测72株标本中生物膜形成相关的菌毛集合系统3个基因、外膜蛋白A基因(ompA)、PER-1型超广谱β-内酰胺酶基因(blaPER-1)及自身合成酶基因abaI的存在情况,并检测intI1阳性率。结果 477株鲍氏不动杆菌对头孢哌酮/舒巴坦与阿米卡星耐药率较低,分别为31.0%和35.0%;72株鲍氏不动杆菌标本中,csuC、csuD、csuE、ompA、blaPER-1、abaI及intI1基因扩增阳性株数分别为61、58、51、63、8、54及45株,阳性率分别为84.7%、80.6%、70.8%、87.5%、11.1%、75.0%及62.5%;abaI和intI1与耐药性差异有统计学意义(P<0.05)。结论青岛市ICU感染鲍氏不动杆菌多为多药耐药菌,鲍氏不动杆菌临床分离菌株生物膜相关基因及intI1基因检出率高,abaI和intI1基因与鲍氏不动杆菌耐药性的产生密切相关,生物膜耐药机制应引起临床医师的重视。OBJECTIVE To find out the distribution and drug resistance of Acinetobacter baumannii isolates in ICUs of Qingdao so as to guide the reasonable clinical prescription,to study the presence of biofilm related genes and the Ⅰclass integrase gene（intI1）in A.baumannii isolates and investigate their relations with drug resistance so as to investigate the A.baumannii biofilm resistance mechanism.METHODS The antibiotic susceptibility testings of 477strains of A.baumanii were performed by using bioMerieux VITEK AMS260or VITEK-2.PCR method was used to detect biofilm formation related genes-3genes of the pili assembly system,outer membrane protein gene ompA,PER-1type extended-spectrum beta-lactamases gene（blaPER-1）,and autoinducer synthase gene abaI;the positive rate of intI1gene was detected at the same time.RESULTS The drug resistance rates of the 477 strains A.baumannii were relatively low to cefoerazone/sulbactam（31.0%）and amikacin（35.0%）.Of all the A.baumannii strains,the number of the strains tested positive with csuC,csuD,csuE,ompA,blaPER-1,abaI and intI1gene amplified were 61,58,51,66,8,54,and 45,respectively,the positive rates were 84.7%,80.6%,70.8%,91.7%,11.1%,75.0%,and 62.5%,respectively;the abaI and intI1 were significantly correlated with the drug resistance（P〈0.05）.CONCLUSION Most of the A.baumannii strains isolated from the ICUs in Qingdao are multidrug-resistant,the detection rates of the biofilm formation related genes and the intI1 are high in the clinical isolates of A.baumannii,the abaIand intI1are closely related to the drug resistance,and the clinicians should pay great attention to the biofilm resistance mechanism.

关 键 词：鲍氏不动杆菌 耐药性 生物膜 Ⅰ类整合酶 基因 

分 类 号：R378[医药卫生—病原生物学]