多药耐药鲍曼不动杆菌耐药基因与其耐药表型关系的分析  

A Study of the Relationship between the Drug-resistant Gene of Multidrug Resistance Acinetobacter Baumannii and its Drug-resistant Phenotype

作　　者：池细俤[1] 高世华[1] 陈家龙[1] 李国玉[1] 林蓉金[1] 

机构地区：[1]福建医科大学附属南平第一医院检验科,福建南平353000

出　　处：《中国实验诊断学》2015年第5期735-739,共5页Chinese Journal of Laboratory Diagnosis

基　　金：福建省南平市科技计划项目资助N2011Z15(1)

摘　　要：目的研究多药耐药鲍曼不动杆菌(MDRAB)的耐药机制,为临床有效治疗该菌感染提供依据。方法应用PCR技术对94株MDRAB进行耐药基因检测,比较8种耐药基因阳性组与阴性组菌株的耐药性。结果耐药基因检出率:VIM 35.1%、SIM 55.0%、TEM 59.6%、OXA-23 93.6%、OXA-24 52.1%、SHV 52.1%、PER-1 83.0%、IMP 2.1%;仅IPM、MEM、SAM在OXA-23基因阳性组与阴性组间,和SAM在SIM基因阳性组与阴性组间的耐药性有显著差异。结论 MDRAB耐药基因检测不能代替常规药敏试验,无法预测临床治疗效果;MH、PO仍为治疗MDRAB的较好选择。Objective OBJECTIVE To investigate the drug-resistant mechanism of Multi-drug Acinetobacter Baumannii （MDRAB）,thus providing a theoretical basis for the effective treatment of MDRAB in clinical.Methods Drugresistant gene sequencings for 94 MDRAB were made by Polymerase Chain Reaction （PCR）.Drug resistances were contrasted between positive group and the negative group of 8 drug resistance genes of MDRAB.Results The detection rates of 8 drug resistance genes were VIM 35.1%,SIM 55.0%,TEM 59.6%,OXA-23 93.6%,OXA-24 52.1%,SHV 52.1%,PER-1 83.0%,IMP 2.1%.Drug resistance of Imipenem （IPM）,meropenem （MEM）,Ampicillin/Sulbactam （SAM）were only found to be significantly different between the positive group and negative group of OXA-23 gene. And drug resistance of SAM was only found to be significantly different between the positive group and negative group of SIM gene.Conclusion This study revealed that drugresistant gene sequencing of MDRAB could not replace the normal drug susceptibility testing,for its unpredictable clinical therapeutic effect.Besides,Minocycline （MH）and Poly-myxin B （PO）were still the better treatment in MDRAB.

关 键 词：鲍曼不动杆菌 多药耐药 基因型 耐药性 

分 类 号：R440[医药卫生—诊断学]