急诊重症监护病房感染患者耐氨基苷鲍曼不动杆菌的耐药机制  

Drug Resistance Mechanism of Patients Infected with Aminoglycoside-resistant Acinetobacter Baumannii in Emergency Intensive Care Unit

作　　者：赵雪[1] 于沛涛[2] 徐芝君[1] 顾清[1] 裘力锋[1] 王弋[1] 

机构地区：[1]杭州市第一人民医院急诊科,杭州310003 [2]北京大学基础医学院,北京100191

出　　处：《医药导报》2014年第5期579-581,共3页Herald of Medicine

摘　　要：目的研究急诊重症监护病房(EICU)感染患者鲍曼不动杆菌16S rRNA甲基化酶armA、氨基苷核苷转移酶ANT(3'')-Ia、氨基苷磷酸转移酶APH(3')-I、氨基苷乙酰转移酶AAC(6')-Ib检出率,分析耐氨基苷鲍曼不动杆菌的耐药机制。方法收集48株鲍曼不动杆菌均经VITEK系统鉴定,并采用琼脂对倍稀释法测定最低抑菌浓度(MIC),采用聚合酶链反应(PCR)法检测酶基因。结果 48株鲍曼不动杆菌中氨基苷类抗菌药物高耐药菌株28株,低耐药菌株20株。高耐药菌16S rRNA armA和低耐药菌16S rRNA armA检出率分别为71.43%和0.00%(P<0.01),高耐药菌APH(3')-I和低耐药菌APH(3')-I检出率分别为60.71%和5.00%(P<0.01),高耐药菌ANT(3'')-Ia和低耐药菌ANT(3'')-Ia检出率分别为82.14%和5.00%(P<0.01),高耐药菌AAC(6')-Ib和低耐药菌AAC(6')-Ib检出率分别为53.57%和5.00%(P<0.01)。结论氨基苷钝化酶和16S rRNA甲基化酶在氨基苷高耐药鲍曼不动杆菌中检出率高,与氨基苷类抗菌药物高耐药密切相关。Objective To investigate drug resistance mechanism of aminoglycoside-resistant Acinetobacter baumannii by detecting 16S rRNA methylase gene and three common genes of aminoglycoside-modifying enzymes in Acinetobacter baumannii infected patients at EICU. Methods The 48 Acinetobacter baumannii strains were collected,and antimicrobial susceptibility tests were performed by VITEK automicroscan. The MIC was detected by 2-fold agar dilution method,and genes were analyzed by polymerase chain reaction（ PCR） . Results Among 48 strains,28 were highly resistant to aminoglycosides and 20 showed lower resistances. The 16S rRNA armA,APH（3′）-I,ANT（3″）-Ia,AAC（6′）-Ib genes were detected in 71. 43%,60. 71%,82. 14%, and 53. 57%of the 28 highly resistant strains,but only present in 0. 00%,0. 05%,0. 05%,and 0. 05%of the low-resistant isolates（P〈0. 01）. Conclusion The aminoglycoside-modifying enzymes and 16S rRNA methylase were frequently found in Acinetobacter baumannii clinical isolates,which is closely related to the high-level resistance to aminoglycoside antibiotics.

关 键 词：鲍曼不动杆菌 氨基苷钝化酶基因 16S rRNA甲基化酶基因 重症监护病房 急诊 

分 类 号：R978.12[医药卫生—药品] R969.3[医药卫生—药学]