鲍氏不动杆菌耐药率与多位点序列分型研究  

Study on drug resistance rate and multilocus sequence typing of Acinetobacter baumannii isolates

作　　者：严正松[1] 陈燕[1] 叶宝东[1] 

机构地区：[1]浙江中医药大学附属第一医院,浙江杭州310018

出　　处：《中华医院感染学杂志》2013年第23期5644-5646,共3页Chinese Journal of Nosocomiology

基　　金：浙江省中医药科学研究基金计划(2013ZB059);浙江省科技计划重大科技基金项目(2008C13005)

摘　　要：目的研究鲍氏不动杆菌的耐药率与分子流行病学规律，明确其进化特征，为临床抗菌药物的应用提供依据。方法2010年5月-2012年9月对187株鲍氏不动杆菌开展体外药物敏感性试验与多位点序列分型（MLST）研究。结果MLST方案中选取的7个管家基因GC含量分布约40．00％；各等位基因数分布于1-8，gltA、gyrB的等位基因数只有1个，gpi的等位基因数有8个；rpoD、gpi的多态性位点最多，分别为7个与9个；体外药物敏感性结果表明，187株鲍氏不动杆菌对8种抗菌药物的耐药率分布于23．6％～53．2％；MLST结果显示，所有菌株共形成4个已知ST型，其中ST92有83株、ST75有57株、ST90有38株、ST137有8株，并发现1株新ST型；上述5个ST型均属于克隆复合体CC92。结论鲍氏不动杆菌对临床常用抗菌药物的耐药率较高，呈多药耐药趋势；鲍氏不动杆菌的分子流行病学趋势相对比较集中，其进化速度较慢，目前需要重点监控以CC92为代表的鲍氏不动杆菌的流行情况，以防其在医院的大规模暴发与流行。OBJECTIVE To study the drug resistant rate and molecular epidemiology of Acinetobacter baumannii, and clarify the evolutionary characteristics, so as to provide basis for clinical use of antibiotics. METHODS The antibiotics susceptibility testing and multilocus sequence typing （MLST） were conducted on 187 Acinetobacter baumannii isolates from May 2010 to Sep. 2012. RESULTS The GC content of seven housekeeping genes selected in MLST scheme were about 40~. The number of alleles ranged from one to eight, and gltA. gyrB only had one allele, while eight in gpi gene alleles. Besides, rpo＇D, gpi possessed the most poiymorphism sites, which were seven and nine respectively. The results of antibiotics susceptibility testing demonstrated that the drug resistance rate to eight antibiotics differed from 23.6% to 53.2% in 187 isolates. MLST research indicated that all isolates clustered into four known STs, of which eighty-three isolates in ST92, fifty-seven isolates in ST75, thirty-eight isolates in STg0, eight isolates in ST137, and one novel ST was found. All five STs mentioned above were classi- fied into one clonal complex CC92. CONCLUSION The drug resistance rates to clinical antibiotics are relatively high in Acinetobacter baumannii, and show a trend of multiple-drug resistance. The molecular epidemiologicai trends of Acinetobacter baumannii are relatively concentrated, and its evolution speed is relatively slow. Our key tasks locate on monitoring the prevalence of CC92 in Acinetobacter baumannii and prevent its major outbreak or prevalence in hospital.

关 键 词：鲍氏不动杆菌 多位点序列分型 管家基因 克隆复合体 

分 类 号：R378[医药卫生—病原生物学]