多药耐药鲍氏不动杆菌外排泵耐药基因及同源性分析  

Study on adeABC efflux pump mechanism in multi-drug resistant Acinetobacter baumannii and homology analysis

作　　者：张海云[1,2] 韩伟东[2] 刘海梅[2] 李刚[3] 王文[3] 贾伟[3] 

机构地区：[1]牡丹江医学院红旗医院检验科,黑龙江牡丹江157011 [2]牡丹江市第一人民医院检验科,黑龙江牡丹江157011 [3]宁夏医科大学总医院医学实验中心,宁夏银川750004

出　　处：《中华医院感染学杂志》2015年第7期1444-1447,共4页Chinese Journal of Nosocomiology

基　　金：黑龙江省卫计委科研基金资助项目(2014-087)

摘　　要：目的分析临床多药耐药鲍氏不动杆菌外排泵耐药基因adeA、adeB、adeC及其调控基因adeR、adeS分布与抗菌药物耐药的关系,为ICU感染鲍氏不动杆菌的同源性有效应对医院感染。方法 2012年ICU检出鲍氏不动杆菌102株,采用K-B法进行药敏试验,PCR测定所有菌株的药物外排泵基因,并利用脉冲场凝胶电泳进行同源性分析。结果 94株耐药鲍氏不动杆菌对头孢唑林和呋喃妥因耐药率均为100.0%,对亚胺培南和氨苄西林/舒巴坦的耐药率为75.8%和95.0%,对其他抗菌药物耐药率均>85.0%;102株鲍氏不动杆菌中adeA、adeB、adeC、adeR、adeS基因型的阳性株分别为78、79、76、77、74株;5种基因均以阴性为主;敏感株中调控基因adeR、adeS表达率较低分别为37.5%和25.0%。结论 ICU分离的鲍氏不动杆菌中呈现严重的多药耐药,adeABC外排泵耐药基因相对于敏感株在耐药菌株中大量存在,外排泵基因的高表达与鲍氏不动杆菌的多药耐药存在相关性关系,而且其基因的播散主要通过克隆播散得以传播。OBJECTIVE To investigate the distribution of efflux system adeABC coding genes （adeA ,adeB ,adeC） and regulating genes （adeR ,adeS） in multi-drug resistant A cinetobacter baumannii ,and analyze the relationship between the distribution and the antibiotic resistance so as to effectively deal with nosocomial infections with the homology of A .baumannii in ICU .METHODS Totally 102 A .baumannii isolates were detected from ICU in 2012 ,and their drug susceptibility testing was carried out by Kirby-Bauer method ,the adeABC efflux pump genotypes of all isolates were identified by PCR and PFGE was used to conduct homology analysis .RESULTS The resistance rate of ninety-four isolates of A .baumannii was 100 .0% to cefazolin ,100 .0% to nitrofurantoin ,75 .8%to imipenem ,95 .0% to ampicillin/sulbactam ,and 〉85 .0% to all other antibacterials .PCR and sequence analysis revealed that there were 78 ,79 ,76 ,77 ,and 74 isolates positive for adeA ,adeB ,adeC ,adeR ,adeS genes of A . baumannii respectively .The five genes were mainly negative .The expressions of regulating genes adeR and adeS were 37 .5% and 25 .0% in sensitive strains .CONCLUSION A .baumannii isolated in ICU has serious multidrug resistance ,adeABC efflux pump genes extensively exist in resistant strains compared to sensitive strains .The high expression of efflux pump genes is correlated to the multidrug resistance of A .baumannii and the spread of these genes is mainly through gene cloning .

关 键 词：鲍氏不动杆菌 药物外排泵 同源性 分析 

分 类 号：R378[医药卫生—病原生物学]