不同地区耐碳青霉烯类鲍氏不动杆菌OXA基因检测及耐药表型分析  

Detection OXAgene in carbapenem-resistant Acinetobacter baumannii isolates from different areas and analysis of drug resistance phenotype

作　　者：高东田[1] 叶小苹[2] 刘元元[1] 刘利华[1] 金呈强[1] 

机构地区：[1]山东省济宁医学院附属医院检验科,山东济宁272029 [2]解放军陆军军官学院院务部门诊部,安徽合肥230031

出　　处：《中华医院感染学杂志》2014年第24期5992-5995,共4页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2010HL038);济宁市科技局基金资助项目(济科字[2011]57)

摘　　要：目的了解不同地区耐碳青霉烯类鲍氏不动杆菌(CRAB)产D类碳青霉烯酶(OXA)基因型及耐药表型状况,为临床用药和有效控制医院感染提供科学依据。方法采用PCR技术进行基因型检测,由Invitrogen公司完成测序,耐药表型和数据统计采用SPSS 17.0软件进行。结果山东济宁医学院附属医院47株和湖北武汉同济医院34株共计81株CRAB标本,blaOXA-23和blaOXA-58型阳性菌株50株(61.7%);其中,山东济宁医学院附属医院21株阳性,阳性率44.7%,blaOXA-23型8株占38.1%,blaOXA-58型12株占57.1%;blaOXA-23和blaOXA-58型均阳性1株;湖北武汉同济医院29株,阳性率85.3%,blaOXA-23型28株占96.6%,blaOXA-23型和blaOXA-58型共同阳性1株。结论两地区CRAB以产blaOXA-23型和blaOXA-58型为主,其中,湖北武汉同济医院以产blaOXA-23型流行株为主,而山东济宁医学院附属医院以产blaOXA-58型流行株为主;同济医院耐药表型少;此研究可为鲍氏不动杆菌耐药性研究、流行菌株和医院感染的防治提供科学依据。OBJECTIVE To observe the genotypes of D‐OXA in the carbapenem‐resistant Acinetobacter baumannii （CRAB）isolates from different areas and analyze the drug resistance phenotypes so as to provide scientific bases for clinical medication and effective control of nosocomial infection .METHODS The genotypes were detected by u‐sing PCR ,the sequencing was performed by the Invitrogen ,and the drug resistance phenotypes and the data were statistically analyzed with the use of SPSS17 .0 software .RESULTS A total of 81 strains of CRAB were collected , including 47 isolates from Affiliated Hospital of Jining Medical College and 34 isolates from Tongji Hospital in Wuhan .Totally 50 （61 .7% ） isolates were tested positive for blaOXA‐23 and blaOXA‐58 ,among which 21 （44 .7% ） isolates were from Affiliated Hospital of Jining Medical College ,including 8 （38 .1% ） isolates positive for blaOXA‐23 ,12 （57 .1% ） isolates positive for blaOXA‐58 ,and 1 isolate positive for both blaOXA‐23 and blaOXA‐58 ,and 29 （85 .3% ） isolates were from Tongji Hospital in Wuhan ,including 28 （96 .6% ） isolates posi‐tive for blaOXA‐23 and 1 isolate positive for both blaOXA‐23 and blaOXA‐58 .CONCLUSION The blaOXA‐23 and blaOXA‐58 are the predominant genotypes in the CRAB isolates from the two areas ,the blaOXA‐23 is preva‐lent in the strains from Tongji Hospital in Wuhan ,and the blaOXA‐58 is prevalent in the strains from Affiliated Hospital of Jining Medical College .There are few of drug resistance phenotypes of the strains from Tongji Hospi‐tal in Wuhan .This study may provide scientific bases for the research of drug resistance of A .baumannii ,preva‐lent strains ,and control of nosocomial infection .

关 键 词：耐碳青霉烯类鲍氏不动杆菌 blaOXA-23 blaOXA-58 聚合酶链反应 耐药表型 

分 类 号：R378[医药卫生—病原生物学]