某院2011年12月-2012年12月ICU亚胺培南耐药鲍曼不动杆菌碳青霉烯酶基因型的研究  

Study on Carbapenemase Genotype of Imipenem-resistant Acinetobacter baumannii in Intensive Care Unit of a Group from Dec. 2011 to Dec. 2012

作　　者：宋晓萍 孙明娥 陈佳红 王健 

机构地区：[1]青岛市海慈医疗集团检验科,山东青岛266033 [2]青岛市妇女儿童医院,山东青岛266011

出　　处：《中国药房》2013年第38期3613-3615,共3页China Pharmacy

摘　　要：目的:对重症监护病房(ICU)临床分离的亚胺培南耐药鲍曼不动杆菌的耐药性及碳青霉烯酶基因型进行研究,为临床防治提供理论依据。方法:收集2011年12月-2012年12月青岛市海慈医疗集团ICU临床分离的亚胺培南耐药鲍曼不动杆菌65株,采用K-B琼脂纸片扩散法进行药敏试验,聚合酶链反应(PCR)检测OXA-23、OXA-24、OXA-51、OXA-58、IMP、VIM 6种碳青霉烯酶基因,并对PCR产物进行测序。结果:65株亚胺培南耐药鲍曼不动杆菌除对头孢哌酮/舒巴坦、阿米卡星、多黏菌素B的耐药率较低外,对其他药物的耐药率均在90%以上。65株扩增出OXA-51基因,56株扩增出OXA-23基因,6株扩增出VIM基因,检出率分别为100%、86.15%、9.23%,OXA-24、OXA-58及IMP均未检出;PCR产物测序表明与GenBank相关基因同源性为100%。结论:该单位ICU亚胺培南耐药鲍曼不动杆菌的耐药现象严重;OXA-23型碳青霉烯酶的产生是鲍曼不动杆菌对碳青霉烯类药物耐药的重要机制之一。OBJECTIVE： To investigate drug resistance and carbapenemases genotype of imipenem-resistant Acinetobacter bau- mannii in Intensive Care Unit （ICU）, so as to provide theoretical basis for clinical prevention and treatment. METHODS： A total of 65 clinical isolates were collected from ICU of Qingdao Hiser Medical Group during Dec. 2011- Dec. 2012. K-B disk diffusion method was adopted in drug susceptibility test; PCR was used to amplify the OXA-23, OXA-24, OXA-51, OXA-58, VIM, IMP genes, and the positive products of genes were sequenced. RESULTS： 65 strains of imipenem-resistant A. baumannii showed low resistant to cefoperazone/sulbactam, amikacin and polymyxin B, while the resistant rates to other antibiotics were more than 90 %. 65 strains amplified OXA-51 gene, 56 strains amplified OXA-23 gene, and 6 strains amplified VIM gene; the detection rates of them were 100%, 86.15% and 9.23% respectively. OXA-24, OXA-58 and IMP genes were not detected. The sequenced results showed that carbapenemases genes were absolutely homologic with GenBank corresponding genes. CONCLUSIONS： Drug resis- tance of imipenem-resistant A. baumannii in ICU of this group is severe. Production of OXA-23 carbapenemase is one of the impor- tant mechanisms of carbapenem-resistant A. baumannii.

关 键 词：鲍曼不动杆菌 重症监护病房 碳青霉烯酶 OXA-23基因 VIM基因 

分 类 号：R969.3[医药卫生—药理学] R378.2[医药卫生—药学]