多重耐药鲍曼不动杆菌β-内酰胺类耐药基因研究  

Study on drug resistance genes for β-lactams in multidrug-resistant Acinetobacter baumannii

作　　者：杨燕[1] 肖慈然[2] 邹玖明[1] 李智山[1] 

机构地区：[1]襄阳市中心医院,湖北襄阳441021 [2]阆中市人民医院,四川阆中637400

出　　处：《中国感染控制杂志》2015年第10期658-662,共5页Chinese Journal of Infection Control

基　　金：襄阳市研究开发计划襄科计[2011]5号

摘　　要：目的了解β-内酰胺类耐药基因在某院临床分离的多重耐药鲍曼不动杆菌(MDRAB)中的流行情况。方法对该院临床分离的22株MDRAB进行药敏试验,同时,采用聚合酶链反应(PCR)技术对其进行β-内酰胺类耐药基因(TEM、SHV、CTX-M、PER、DHA、IMP、VIM、SIM、OXA-23、OXA-24、OXA-58)检测。结果 22株MDRAB对头孢他啶、头孢噻肟、头孢吡肟、庆大霉素、阿米卡星、环丙沙星和复方磺胺甲口恶唑耐药率均为100.00%;对亚胺培南、美罗培南、头孢哌酮/舒巴坦的耐药率分别为50.00%、40.91%、31.82%,中介率分别为31.82%、36.36%、31.82%。22株(100.00%)MDRAB均携带耐药基因OXA-23群,16株(72.73%)携带TEM,12株(54.55%)携带IMP,4株(18.18%)携带PER;SHV、CTX-M、DHA、VIM、SIM、OXA-24群、OXA-58群基因检测均为阴性。结论携带IMP、TEM、PER、OXA-23耐药基因是导致该院MDRAB对β-内酰胺酶类抗生素耐药的重要机制。Objective To investigate prevalence of resistance genes forβ-lactams in clinically isolated multidrugresistant Acinetobacter baumannii（MDRAB）in a hospital.Methods 22 clinically isolated MDRAB strains were performed antimicrobial susceptibility testing,resistance genes forβ-lactams（TEM,SHV,CTX-M,PER,DHA,IMP,VIM,SIM,OXA-23,OXA-24,and OXA-58）in these strains were detected with polymerase chain reaction.Results The resistant rates of 22 isolates of MDRAB to ceftazidime,cefotaxime,cefepime,gentamycin,amikacin,ciprofloxacin,and compound sulfamethoxazole were all 100.00%;to imipenem,meropenem,and cefoperazone/sulbactam were 50.00%,40.91%,and 31.82% respectively,intermediated rates were 31.82%,36.36%,and31.82% respectively.The carriage rates of OXA-23,TEM,IMP,and PER were 100.00%（n=22）,72.73 %（n=16）,54.55%（n=12）,and 18.18%（n=4）respectively.Detection results of SHV,CTX-M,DHA,VIM,SIM,OXA-24,and OXA-58 were all negative.Conclusion Carriage of IMP,TEM,PER,and OXA-23 resistance genes are the major resistance mechanisms of MDRAB toβ-lactamase antimicrobial agents in this hospital.

关 键 词：鲍曼不动杆菌 超广谱Β-内酰胺酶 Β-内酰胺类 耐药基因 抗药性 微生物 多重耐药 

分 类 号：R378.99[医药卫生—病原生物学]