鲍曼不动杆菌的耐药性及β-内酰胺酶耐药基因的研究  

Study onβ-lactamase resistance genes of Acinetobacter baumannii resistance to β-lactams

作　　者：邓丽华[1] 施德仕[1] 杨荣胜[1] 许美荣[1] 胡莉萍[1] 

机构地区：[1]徐州医学院附属医院检验科,江苏徐州221002

出　　处：《中国实验诊断学》2013年第7期1180-1183,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的了解临床分离的鲍曼不动杆菌耐药性及β-内酰胺酶耐药基因的存在类型。方法用美国BD公司Phoenix-100型全自动细菌鉴定药敏系统鉴定细菌及做药敏试验,用聚合酶链反应(PCR)方法检测5种常见β-内酰胺酶耐药基因。采用随机引物PCR扩增对菌株进行分型。结果 50株鲍曼不动杆菌对多粘菌素B全部敏感,,而对其余18种抗生素耐药率为52%-100%,其中24株为泛耐药菌株,共分为8种基因型,B型菌株为主要的流行株,所有菌株均检出TEM-1基因,46株检出AmpC基因,31株检出0XA-24基因、21株检出0XA-23基因,7株检出IMP基因。结论临床分离的鲍曼不动杆菌主要以引起危重病人的呼吸道感染为主,对18种临床常用抗生素耐药率高,对头孢菌素类高度耐药并且存在克隆传播,同时携带多种耐药基因是本院鲍曼不动杆菌对β-内酰胺酶类抗菌药物耐药的主要原因。Objective To investigate resistance and β-lactamase resistance genes related, of Acinetobacter baumannii isolates. Methods Identification and susceptibility of isolates were detected by BD Phoenix-100 automatic bacterial i- dentification and susceptibility system （USA）. Five common β-lactamase resistance genes were detected by polymerase chain reaction （PCR）. Isolates were typed by PCR amplification with random primers. Results All 50 isolates were sensitive to polymyxin B,while resistance rates remaining the 18 antibiotics were from 52% to 100%. 24 isolates were pan-resistant strains which were divided into eight genotypes. Genotyp B was the major epidemic type in 50 isolates. TEM-1 gene was detected in All 50 isolates,AmpC gene in 46 isolates,0XA-24 gene in 31 isolates,OXA-23 gene in 21 isolates,and IMP gene in 7 isolates. Conclusion Acinetobacter baumannii isolates mainly cause respiratory infections in critically ill patients. The resistance rates of 18 common antibiotics, cephalosporins especially, were high in Acinetobact- er baumannii isolates. Clone spread of the isolates carrying multipl genes of β-lactamases was the main reason for anti- microbial resistance of Acinetobacter baumannii in our hospital.

关 键 词：鲍曼不动杆菌 Β-内酰胺酶 耐药基因 

分 类 号：R440[医药卫生—诊断学]