多利培南对18株产OXA-58型碳青霉烯酶鲍曼不动杆菌的抗菌活性  

Antibacterial activity of doripenem against 18 Acinetobacter baumannii with oxacillinases-58 carbapenemase

作　　者：田雪[1] 唐昊[1] 靳钰[1] 修清玉[1] 

机构地区：[1]上海长征医院呼吸内科,上海200003

出　　处：《上海医学》2014年第4期321-324,共4页Shanghai Medical Journal

基　　金：十二五"重大新药创制"(2011ZX09302-003-01);国家自然科学基金面上项目(81170025)基金资助

摘　　要：目的了解上海长征医院临床分离鲍曼不动杆菌中苯唑西林酶-58(OXA-58)基因存在状况,以及多利培南对其抗菌活性。方法收集上海长征医院分离的72株鲍曼不动杆菌,通过聚合酶链反应(PCR)扩增和克隆测序等方法对鲍曼不动杆菌中OXA-58基因进行检测和测序分析,区分出OXA-58基因阳性和OXA-58基因阴性鲍曼不动杆菌。通过微量稀释法检测碳青霉烯类抗生素多利培南、亚胺培南、美罗培南对鲍曼不动杆菌的最低抑菌浓度(MIC),并分别对多利培南、亚胺培南、美罗培南对OXA-58基因阳性鲍曼不动杆菌的MIC,多利培南对OXA-58基因阳性和OXA-58基因阴性鲍曼不动杆菌的MIC进行统计学分析。结果72株鲍曼不动杆菌中,OXA-58基因阳性率为25%。多利培南对鲍曼不动杆菌的半数MIC(MIC50)、90%MIC(MIC90),以及对OXA-58基因阳性鲍曼不动杆菌的MIC均显著低于亚胺培南和美罗培南(P值均<0.01)。多利培南对OXA-58基因阳性鲍曼不动杆菌的平均MIC、MIC50、MIC90均显著低于其对OXA-58基因阴性鲍曼不动杆菌(P值均<0.01)。结论 OXA-58型碳青霉烯酶是鲍曼不动杆菌耐药的原因。多利培南对产OXA-58型碳青霉烯酶鲍曼不动杆菌的MIC50、MIC90均低于不产OXA-58型碳青霉烯酶鲍曼不动杆菌。相比亚胺培南、美罗培南,多利培南对携带OXA-58基因的鲍曼不动杆菌具有更低的MIC。Objective To detect oxacillinases-58 （OXA-58） gene of Acinetobacter baumannii isolated in Shanghai Changzheng Hospital and antibacterial activity of doripenem. Methods A total of 72 strains of Acinetobacter baumannii were collected in Shanghai Changzheng Hospital, then the detection and sequencing of Acinetobacter baumannii carbapenemase OXA-58 gene were performed through polymerase chain reaction （PCR） amplification and cloning. According to the detection results, the strains were divided into OXA-58 positive group and OXA-58 negative group. Minimum inhibitory concentration （MIC） of doripenem, imipenem and meropenem to Acinetobacter baumannii was measured through microdilution. MIC of doripenem, imipenem and meropenem in OXA-58 positive group and MIC of doripenem in OXA-58 positive and negative groups were statistically analyzed. Results The positive rate of OXA-58 gene of 72 Acinetobacter baumannii was 25%. MIC50 and MIC90 of doripenem to Acinetobacter baumannii were significantly lower than imipenem and meropenem （all P〈O. 01 ）. In OXA-58 positive group, MIC of doripenem was significantly lower than imipenem and meropenem （both P〈O. 01 ）. MIC, MIC50 and MIC90 of doripenem in OXA-58 positive group were significantly lower than those in OXA-58 negative group （all P〈O. 01）. Conclusion Acinetobacter baumannii carbapenemase OXA-58 gene can result in Acinetobacter baumannii resistance. MIC50 and MIC90 of doripenem to Acinetobacter baumannii carrying OXA-58 gene are lower than those without OXA-58 gene. MIC of doripenem to Acinetobacter baumannii with carbapenemase OXA-58 gene is lower than that of mipenern and meropenem. （Shanghai Med J, 2014, 37： 321-324）

关 键 词：鲍曼不动杆菌 碳青霉烯酶 苯唑西林酶-58 抗菌活性 

分 类 号：R446.5[医药卫生—诊断学]