呼和浩特地区耐亚胺培南鲍曼不动杆菌耐药性及OXA基因检测  

Detection of antimicrobial resistance and OXA genes in imipenem-resistant Acinetobacter baumannii from Hohhot region

作　　者：刘超梅[1] 李雪梅 陈志英[1] 郑小华 郭素芳[4] 

机构地区：[1]解放军第253医院,内蒙古呼和浩特010051 [2]北京军区石家庄药材供应站,河北石家庄050082 [3]内蒙古人民医院,内蒙古呼和浩特010017 [4]内蒙古医科大学附属医院,内蒙古呼和浩特010050

出　　处：《中国感染控制杂志》2015年第5期289-293,共5页Chinese Journal of Infection Control

基　　金：内蒙古自治区自然科学基金(2010MS1129)

摘　　要：目的了解呼和浩特地区临床分离耐亚胺培南鲍曼不动杆菌（IRAB）的耐药性和OxA碳青霉烯酶基因携带情况，为预防和控制多重耐药鲍曼不动杆菌医院感染提供依据。方法收集2012年1—12月3所呼和浩特三级甲等医院患者临床分离的非重复IRAB49株，采用纸片扩散法进行药敏试验，应用聚合酶链反应（PCR）检测4种oXA碳青霉烯酶基因（blaOXA-51-like、blaOXA-23-like、blaOXA-24-like、blaOXA-58-like）的携带情况。结果49株IRAB对米诺环素的耐药率（8．16％）较低，对其他抗菌药物均具有较高的耐药率（81．63％～100．00％）。49株IRAB均携带blaOXA-23-like基因（检出率为100．00％），其中42株同时携带blaOXA-23-like基因（检出率为85．71％）；3所医院均检出blaOXA-23-like、blaOXA-51-like基因，均未检出blaOXA-24-like、blaOXA-58-like。结论IRAB呈多重耐药现象，对米诺环素耐药率最低；该地区IRAB的主要耐药机制是产OXA-23型碳青霉烯酶。Objective To realize antimicrobial resistance and carrying status of OXA carbapenemase among imipenem-resistant Acinetobacter baumannii （IRAB）isolated from patients of Hohhot, so as to provide guidance for the prevention and control of healthcare-associated infection（HAI） caused by multidrug-resistant Acinetobacter bauman- nil. Methods 49 IRAB isolates from 3 tertiary first-class hospitals in Hohhot between January and December 2012 were collected, antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method, four geno- types（blaOXA-51-like,blaOXA-23-like , blaOXA-24-like, blaOXA-58-like） of OXA carbapenemase were detected by polymerase chain reaction （PCR）. Results All 49 isolated IRAB strains were found to be highly resistant to antimicrobial agents （81. 63%-100.00%） except to minocycline （8. 16%） ; blaOXA-51-like was identified in 49 strains （ 100. 00%）, 42 （85.71%）of which also carried blaOXA-23-like gene , blaOXA-23-like and blaOXA-51-like were both found in three hospital,blaOXA-24-like, and blaOXA-58-like, weren＇t found. Conclusion IRAB strains present multidrug resistance, resistant to mi- nocycline is the lowest; blaOXA-23-like, is the main drug-resistance mechanism of IRAB in Hohhot.

关 键 词：鲍曼不动杆菌 抗药性 微生物 耐碳青霉烯酶 OXA基因 合理用药 

分 类 号：R181.32[医药卫生—流行病学] R378.99[医药卫生—公共卫生与预防医学]