临床多药耐药鲍氏不动杆菌分布及β-内酰胺酶基因型分析  

Clinical distribution of multidrug-resistant Acinetobacter baumannii and β-lactamase genotypes

作　　者：张雨晨 王春艳 查渝 曹晓光 黄羽 周树生 ZHANG Yu-chen;WANG Chun-yan;ZHA Yu;CAO Xiao-guang;HUANG Yu;ZHOU Shu-sheng(Affiliated Provincial Hospital of Anhui Medical University,Hefei ,Anhui 230000,China)

机构地区：[1]安徽医科大学附属省立医院重症医学科

出　　处：《中华医院感染学杂志》2019年第1期1-5,共5页Chinese Journal of Nosocomiology

基　　金：安徽省自然科学基金资助项目(1608085MH214)

摘　　要：目的调查多药耐药鲍氏不动杆菌的分布及β-内酰胺酶耐药基因的流行情况。方法收集2017年6月-8月安徽省立医院住院患者标本中分离得到的多药耐药鲍氏不动杆菌(Multidrug-resistant Acinetobacter baumannii,MDRAB)菌株。采用VITEK-2COMPACT全自动微生物分析仪进行菌株鉴定及药敏试验。应用PCR法检测β-内酰胺酶耐药基因。结果 71例多药耐药鲍氏不动杆菌主要来自ICU占67.6%,大多来源于痰标本占84.5%。对10种常用抗菌药物耐药率为79.4%-100.0%,其中对头孢菌素类、环丙沙星以及亚胺培南的耐药率均为100.0%。检测出的β-内酰胺酶耐药基因有blaOXA-23(90.1%,64例)、blaTEM(66.2%,47例)、blaKPC(1.4%,1例)和blaSHV(1.4%,1例),其中1例菌株同时携带blaKPC、blaSHV以及blaTEM三个耐药基。结论医院多药耐药鲍氏不动杆菌情况较严重,β-内酰胺酶相关耐药基因广泛存在于多药耐药鲍氏不动杆菌中,多药耐药鲍氏不动杆菌对β-内酰胺类抗菌药物耐药可能与β-内酰胺酶耐药基因表达相关。OBJECTIVE To investigate the distribution of multidrug-resistant Acinetobacter baumannii(MDRAB)strains and analyze the prevalence ofβ-lactamase drug resistance genes.METHODS The MDRAB strains were isolated from the specimens of the patients who were hospitalized in Affiliated Provincial Hospital of Anhui Medical University from Jun 2017 to Aug 2017,the isolated strains were identified by using VITEK-2 COMPACT automatic microorganism analyzer,the drug susceptibility testing was performed,and theβ-lactamase drug resistance genes were detected with the use of PCR.RESULTS Of 71 strains of MDRAB,67.6% were isolated from ICU,84.5% of which were isolated from sputum specimens.The drug resistance rates of the strains to the 10 types of commonly used antibiotics varied from 79.4%to 100.0%,the drug resistance rates to cephalosporins,ciprofloxacin and imipenem were 100.0%.Among the strains that were detected with theβ-lactamase drug resistance genes,64(90.1%)were detected with blaOXA-23,47(66.2%)were detected with blaTEM,1(1.4%)was detected with blaKPC,and 1(1.4%)was detected with blaSHV,and 1 was carried with blaKPC,blaSHVand blaTEM.CONCLUSION The MDRAB strains are highly drug-resistant,theβ-lactamase drug resistance genes are prevalent among the MDRAB strains,and the drug resistance of the MDRAB strains to theβ-lactams antibiotics may be related to the expression of theβ-lactamase drug resistance genes.

关 键 词：鲍氏不动杆菌 多药耐药 β-内酰胺酶类耐药基因 耐药率 

分 类 号：R378[医药卫生—病原生物学]