多重耐药鲍曼不动杆菌耐药情况及其携带耐消毒剂基因的研究  

Multi-drug resistant Acinetobacter baumannii resistant and carry disinfectant-resistant gene research

作　　者：王正兰[1] 李临平[1] 李雪[1] 段秋红[1] 杨晓文[1] 张小玲[1] 梁红萍[2] 张燕军[2] 

机构地区：[1]山西省人民医院院感科,太原市030012 [2]山西省人民医院院检验科,太原市030012

出　　处：《实用检验医师杂志》2015年第4期207-210,共4页Chinese Journal of Clinical Pathologist

基　　金：山西省卫生厅科技攻关项目(201301031)

摘　　要：目的了解多重耐药鲍曼不动杆菌的耐药情况及携带耐消毒剂基因情况。方法收集2014年1月-2015年2月山西省两所三级甲等医院50株多重耐药鲍曼不动杆菌,采用K-B法检测抗菌药物的敏感性,采用聚合酶链反应(polymerase chain reaction,PCR)检测耐消毒剂基因qac EΔ1。结果50株多重耐药鲍曼不动杆菌主要见于神经外科、ICU、呼吸内科,分别为15株(30.0%)、10株(20.0%)、9株(18.0%)。其中痰标本34株(68.0%)、创面分泌物标本2株(4.0%)、血标本2株(4%)、尿液标本5株(10.0%)、引流物标本2株(4.0%)、神经外科患者病床栏杆表面标本5株(10.0%)。50株多重耐药鲍曼不动杆菌对氨苄西林/舒巴坦的耐药率为96.0%(48/50)、左氧氟沙星为70.0%(35/50)、头孢他啶为100.0%(50/50)、头孢哌酮/舒巴坦为100.0%(50/50)、亚胺培南为98.0%(49/50)。50株多重耐药鲍曼不动杆菌中,有21株携带耐消毒剂基因qac EΔ1,阳性率为42.0%。结论多重耐药鲍曼不动杆菌耐药情况十分严重,并且携带有耐消毒剂基因qac EΔ1。因此,应严格规范使用抗菌药物,并采取相应的措施预防多重耐药鲍曼不动杆菌在医院环境中流行爆发。Objective To understand the situation of disinfectant- resistant gene and drug resistance of multi-drug resistant Acinetobacter baumannii. Methods 50 strains multi-drug resistant Acinetobacter bau- mannii were collected in two grade third A class hospitals of Shanxi province from January 2014 to February 2015. The sensitivity of antibacterial agents were tested by K-B method. Disinfectant resistant gene qacEA1 was detected by polymerase chain reaction. Results 50 strains multi-＇drug resistant Acinetobacter baumannii were mainly distributed in department of neurosurgeons, ICU and department of respiration, which were 15 strains （30.0%）, 10 strains （20.0%）, 9 strains （ 18.0% ）, respectively. There were 34 strains sputum specimens （68.0%）, 2 strains surgical wounds specimens （4.0%）, 2 strains blood specimens （4.0%）, 5 strains urine specimens （10.0%）, 2 strains drainage specimens （4.0%） and 5 strains specimens of bed handrail in depart- ment of neurosurgeons patients （10.0%） in 50 strains multi-drug resistant A cinetobacter baumannii. Drug re- sistance of 50 strains multi-drug resistant Acinetobacter baumannii to ampicillin/sulbactam, levofloxacin, ceftazidime, cefoperazone/sulbactam, imipenem were 96.0% （48/50）, 70.0% （35/50）, 100.0% （50/50）, 100.0%（50/50）, 98.0%（49/50）, respectively. There were 21 strains multi-drug resistant Acirtetobacter bau- mannii with disinfectant- resistant gene qacEA1 in 50 strains multi-drug resistant A cinetobacter baumannii, and the positive rate was 42.0%. Conclusion The drug resistant situation of muhi-drug resistant A c inetobac- ter baumannii is very serious, and carry disinfectant- resistant gene qacEA1. Therefore, it should be strictly regulate use of antimicrubial agents, and take corresponding measures to preventing epidemic outbreak of mul- ti-drug resistant A cinetobacter baumannii in hosnital.

关 键 词：多重耐药菌 鲍曼不动杆菌 药敏试验 消毒剂 耐消毒剂基因 qac EΔ1 K-B法 

分 类 号：R446.5[医药卫生—诊断学]