泛耐药鲍氏不动杆菌耐药元件检测研究  

Detection of drug resistance elements in pandrug-resistant Acinetobacter baumannii

作　　者：鲍群丽[1] 汪宏良[1] 王春新[2] 柯俊[1] 周朕[3] 

机构地区：[1]黄石市中心医院检验科,湖北黄石435000 [2]无锡市人民医院检验科,江苏无锡311106 [3]黄石市中心医院呼吸内科,湖北黄石435000

出　　处：《中华医院感染学杂志》2016年第2期254-256,334,共4页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(2015CFB627)

摘　　要：目的探讨黄石市和无锡市两所医院临床分离的泛耐药鲍氏不动杆菌(PDRAB)菌株之间亲缘关系。方法收集分离自黄石市中心医院(A院)和无锡市人民医院(B院)PDRAB各20株,用mdfA测序确认菌种,再采用聚合酶链反应(PCR)及序列分析的方法分析32种β-内酰胺类药物获得性耐药基因、1种膜孔蛋白基因、15种氨基糖苷类药物获得性耐药基因、1种获得性外排泵泵蛋白基因、10种可移动遗传元件遗传标记,最后对测得结果作样本聚类分析(UPGMA法)。结果 A院与B院β-内酰胺类获得性耐药基因均检出blaTEM、blaADC、bla OXA-23群、bla OXA-51群基因,且阳性率均为100.0%;膜孔蛋白carO基因A院均为缺失型100.0%,B院均为突变型100.0%,但两所医院PDRAB膜孔蛋白carO基因均为异常型;氨基糖苷类药物获得性耐药基因A院aph3-Ⅰ检出率为100.0%,但其他基因检出率低;B院aac(6′)-Ⅰb、ant(3″)-Ⅰ、aph3-Ⅰ、armA检出率均为100.0%;可移动遗传元件标记A院intⅠ1、ISaba1、IS26阳性率分别达100.0%、100.0%、95.0%;B院intⅠ1、tnpU、tnp513、ISaba1、IS26阳性率均达100.0%;样本聚类分析提示A院与B院40株PDRAB分不同的簇群。结论 A院与B院PDRAB尽管耐药谱相同,但遗传背景不同,样本聚类分析是监控医院感染的实用手段。OBJECTIVE To investigate the genetic relationship between the clinical isolates of pandrug-resistant Acinetobacter baumannii（PDRAB）from Huangshi and the clinical isolates from Wuxi.METHODS Totally 20 strains of PDRAB isolated from The Central Hospital of Huangshi（Hospital A）and 20 strains of PDRAB isolated from the People′s Hospital of Wuxi were collected,the strains were identified by using mdfAsequencing,then 32 kinds of acquired resistance genes to beta-lactams,1kind of porin gene,15 kinds of acquired resistance genes to aminoglycosides,1kind of acquired efflux pump protein gene,and 10 kinds of genetic markers of mobile genetic elements were analyzed by means of polymerase-chain-reaction（PCR）and sequence analysis,and finally the sample cluster analysis was performed for the sequencing results by UPGMA method.RESULTS The acquired resistance genes to beta-lactams were detected positive in both hospital A and hospital B,including blaTEM,blaADC,cluster bla OXA-23,and cluster bla OXA-51,and all the positive rates were 100.0%.The positive rate of deletion type of porin carOgene was 100.0%in hospital A,and the positive rate of mutant porin carOgene was 100.0%,however,the porin carOgene was abnormal in the PDRAB strains isolated from the two hospitals.The detection rate of the acquired resistance gene to aminoglycosides aph3-Ⅰ was 100.0% in hospital A,while the detection rates of other genes were low;the detection rates of aac（6′）-Ⅰb,ant（3″）-Ⅰ,aph3-Ⅰ,and armA genes were100.0%in hospital B.The positive rates of the genetic markers of mobile genetic elements intⅠ1,ISaba1,and IS26 were respectively 100.0%,100.0%,and 95.0%in hospital A;the positive rates of intⅠ1,tnpU,tnp513,ISaba1,and IS26 were 100.0%in hospital B.The sample cluster analysis indicated that the 40 strains of PDRAB isolated from hospital A and hospital B could be divided into different clusters.CONCLUSION Although the drug resistance phenotypes of the PDRAB strains are the same in hospital A as in hospital B,the geneti

关 键 词：鲍氏不动杆菌 泛耐药 耐药基因 可移动遗传元件 样本聚类分析 

分 类 号：R378[医药卫生—病原生物学]