ICU患者感染泛耐药鲍氏不动杆菌携带OXA酶与AmpC酶的研究  

Pan-resistant Acinetobacter baumannii carrying blaOXA and blaAmpC in ICU

作　　者：郭宇航[1] 范学财[1,2] 张吉生[1] 王勇[1] 曼萨 王宇超[1] 张晓丽[1] 

机构地区：[1]佳木斯大学附属第一医院检验科,黑龙江佳木斯154003 [2]佳木斯大学附属第二医院检验科,黑龙江佳木斯154003

出　　处：《中华医院感染学杂志》2016年第4期727-729,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省自然科学基金资助项目(D201224);黑龙江省卫生厅科研基金资助项目(2013-226);佳木斯大学研究生科技创新基金资助项目(LZZ2014_022)

摘　　要：目的了解ICU患者感染泛耐药鲍氏不动杆菌携带碳青霉烯酶基因、头孢菌素酶(AmpC酶)基因,从而分析其耐药机制。方法常规细菌培养方法分离细菌,用VITEK-2全自动微生物鉴定/药敏测试系统进行菌种鉴定及体外敏感测定;采用多重PCR检测25株鲍氏不动杆菌携带的碳青霉烯酶、AmpC酶相关耐药基因(16S rRNA、OXA-23、OXA-24、OXA-51、OXA-58、ADC、DHA、ISAba1),并对耐药基因扩增的阳性产物进行DNA序列分析。结果 ICU患者感染泛耐药鲍氏不动杆菌均携带OXA-23、OXA-51、ADC基因,21株携带插入序列ISAba1;DNA序列分析结果显示,OXA-23、OXA-51、ADC分别与NCBI的序列同源性均为99.0%。结论产OXA-23型碳青霉烯酶可能是ICU患者感染鲍氏不动杆菌对碳青霉烯酶类抗菌药物耐药的主要原因,且为同一克隆株传播。OBJECTIVE To investigate carbapenemase related resistant genes OXA and AmpC of pan-resistant Acinetobacter baumannii（PDRAB）in ICU and to further analyze the resistance mechanism.METHODS A.baumannii were isolated from specimens of patients by conventional culture method and the VITEK-II automated microbial system was used for strain identification and in vitro susceptibility test.Multiplex PCR detection method was used to identify 25 A.baumannii strains carrying carbapenemase and AmpCrelated resistant genes OXA-23,OXA-24,OXA-51,OXA-58,ADC,DHA and ISAba1,and the positive amplified products of resistant genes were subjected to DNA sequence analysis.RESULTS The selected PDA samples showed all strains carried OXA-51,OXA-23 and ADCgenes.Out of 23 PDA strains,21 carried ISAba1genes.DNA sequence analysis of OXA-23,OXA-51 and ADC with the NCBI sequence showed 99% homology.CONCLUSION OXA-23 producing gene which spread by the same clone may be the main cause of resistance of A.baumannii to carbapenem antimicrobial agents.

关 键 词：泛耐药鲍氏不动杆菌 碳青酶烯酶 头孢菌素酶 插入序列ISAba1 

分 类 号：R378[医药卫生—病原生物学]