耐碳青霉烯类鲍氏不动杆菌基因检测与耐药性研究  

Genotyping and drug resistance of carbapenem-resistant Acinetobacter baumannii

作　　者：董春忠[1] 燕吉广[1] 周卫岭[1] 孙霞 朱元祺[3] 

机构地区：[1]滨州市人民医院检验科,山东滨州256610 [2]滨州市妇幼保健院,山东滨州256610 [3]青岛大学附属医院检验科,山东青岛266003

出　　处：《中华医院感染学杂志》2015年第22期5045-5048,共4页Chinese Journal of Nosocomiology

基　　金：山东省科技发展计划基金资助项目(2009GG10002057);青岛经济技术开发区重点科技发展基金资助项目(2013-1-82)

摘　　要：目的研究耐碳青霉烯类鲍氏不动杆菌基因及其耐药性,为临床治疗与感染控制提供依据。方法收集医院2013年8-11月临床送检标本分离的非重复耐碳青霉烯类鲍氏不动杆菌26株,采用Phoenix100微生物全自动鉴定系统进行菌株鉴定及药敏试验;PCR方法扩增菌株的碳青霉烯酶B类和D类基因;阳性产物经ABI基因测序仪测序确认。结果 26株耐碳青霉烯类鲍氏不动杆菌对多黏菌素无耐药株,对四环素、阿米卡星、庆大霉素、磺胺甲噁唑/甲氧苄啶耐药率分别为11.5%、73.1%、92.4%、96.2%,对其余11种抗菌药物耐药率均为100.0%;26株鲍氏不动杆菌中检出blaOXA-64、blaOXA-51和blaOXA-23阳性率100.0%;blaIMP-1基因阳性率69.2%,未检出blaOXA-24、blaOXA-48、blaOXA-55、blaOXA-58、blaOXA-60、blaOXA-66、blaVIM-2和blaVIM-7基因。结论医院耐碳青霉烯类鲍氏不动杆菌主要碳青霉烯酶基因是blaOXA-23、blaOXA-51、blaOXA-64及blaIMP-1;blaOXA-64、blaIMP-1耐药基因共存同一菌株,是医院耐碳青霉烯类鲍氏不动杆菌的特点,与其他地区不同,医院鲍氏不动杆菌已呈现多药耐药应引起临床重视。OBJECTIVE To explore the genotypes of the carbapenem‐resistant Acinetobacter baumannii and analyze the drug resistance so as to provide guidance for clinical control and treatment of infection .METHODS A total of 26 strains of non‐repetitive carbapenem‐resistant A .baumannii were isolated from the submitted clinical specimens that were collected from Aug 2013 to Nov 2013 ,then the bacterial identification was carried out by using Phoe‐nix100 microorganism automatic identification system ,the drug susceptibility testing was performed ,the group B and D carbapenemase genes of the strains were amplified with the use of PCR method ,and the positive products were sequenced and confirmed through ABI sequencing instrument .RESULTS Of 26 strains of carbapenem‐resist‐ant A .baumannii ,no strain was resistant to polymycin ,the drug resistance rates to tetracycline ,amikacin ,genta‐micin ,and sulfamethoxazole‐trimethoprim were 11 .5% ,73 .1% ,92 .4% ,and 96 .2% ,respectively ,and the drug resistance rates to the rest of 11 antibiotics were 100 .0% .The positive rates of detection of blaOXA‐64 ,blaOXA‐51 and blaOXA‐23 were 100 .0% in the 26 strains of A .baumannii;the positive rate of the blaIMP‐1 gene was 69 .2% ;the genotypes that were detected negative were as follows ：blaOXA‐24 , blaOXA‐48 , blaOXA‐55 , blaOXA‐58 ,blaOXA‐60 ,blaOXA‐66 ,blaV IM‐2 ,and blaV IM‐7 .CONCLUSION The main carbapenemase geno‐types of the carbapenem‐resistant A .baumannii include blaOXA‐23 ,blaOXA‐51 ,blaOXA‐64 and blaIMP‐1 .The drug resistance genes of blaOXA‐64 and blaIMP‐1 coexist in the same strain ,which is the characteristic of the clinical carbapenem‐resistant A .baumannii strains and differs from the strains isolated from other regions .It is necessary for the hospital to pay high attention to the multidrug‐resistant A .baumannii strain .

关 键 词：鲍氏不动杆菌 碳青霉烯酶 耐药性 基因 

分 类 号：R378[医药卫生—病原生物学]