鲍氏不动杆菌D类碳青霉烯酶及插入序列ISAba1研究  

Study on the OXA carbapenemase and ISAba1 of Acinetobacter baumannii strains

作　　者：于文静[1] 李桂玲[1] 张和光[1] 多丽波[1] 孟祥兆[1] 王兴力[1] 齐桂云[1] 孙琪[1] 

机构地区：[1]哈尔滨医科大学附属第二医院检验科,黑龙江哈尔滨150086

出　　处：《中华医院感染学杂志》2015年第4期721-723,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省卫生厅基金资助项目(2011-103)

摘　　要：目的研究临床分离耐亚胺培南鲍氏不动杆菌(IRAB)的耐药性、D类碳青霉烯酶及ISAba1流行情况,为临床合理用药及抗感染提供依据。方法收集医院2011年10月-2012年6月分离的鲍氏不动杆菌(ABA)140株,多重PCR鉴定ABA ITS基因型,K-B纸片法进行药敏试验,改良Hodges试验对产碳青霉烯酶菌株初筛,多重PCR检测D类碳青霉烯酶及整合酶基因,PCR方法分别检测blaOXA-23-like和blaOXA-51-like上游ISAba1,对部分blaOXA-23-like、blaOXA-24-like、blaOXA-51-like阳性菌株测序并确定基因型。结果 140株ABA经扩增16S-23SrRNA基因间隔序列后137株基因型是ABA;124株为IRAB,13株为亚胺培南敏感鲍氏不动杆菌(ISAB),IRAB对大多数抗菌药物的耐药率>90.00%;blaOXA-23-like、blaOXA-51-like基因检出率,分别为91.24%、94.89%,未检测到blaOXA-58-like基因;部分blaOXA-23-like、blaOXA-24-like、blaOXA-51-like阳性菌株全基因测序后分别为OXA-23、OXA-72、OXA-66。结论哈尔滨地区鲍氏不动杆菌耐药情况十分严重,OXA-23型酶是其耐药的主要原因,ISAba1对其表达起主要作用。OBJECTIVE To investigate antibiotic resistant profile of IRAB,the epidemiology of OXA carbapenemase and ISAba1 in clinical isolates,so as to provide the reference for rational use of antibiotics and control of nosocomial infections.METHODS Totally 140 strains of Acinetobacter baumannii isolated from Oct.2011 to Jun.2012 in the hospital were collected.A multiplex PCR was designed to investigate the genotype of the ITS sequence of ABA.Antibiotic resistance was tested by K-B method.Carbapenemase strains were primarily screened by the modified Hodges test.The OXA carbapenemase and integrase gene were determined by multiplex PCR.A single PCR was carried out to detect the ISAba1 upstream of blaOXA-23-like and blaOXA-51-like.Some positive strains of blaOXA-23-like,blaOXA-24-like,blaOXA-51-like were sequenced and gene determined by PCR.RESULTS Of 140 strains identified by multiplex PCR,137 strains were ABA,124 strains were IRBA and 13 were ISBA.The resistance rate of IRAB to most antibacterials was over 90.00%.The gene detection rate of blaOXA-51-like,blaOXA-23-like were 91.24% and 94.89% respectively.No blaOXA-58-like gene was found.After whole genome sequencing,the genotypes were OXA-23,OXA-72 and OXA-66,respectively.CONCLUSION ABA from Harbin region is seriously resistant to all the antibiotics,and OXA-23 is the major cause.ISAba1 plays an important role in the expression of OXA-23..

关 键 词：鲍氏不动杆菌 D类碳青霉烯酶 整合酶基因 

分 类 号：R378[医药卫生—病原生物学]