耐碳青霉烯鲍氏不动杆菌耐药性与耐药基因检出关系探讨  

Relationship between drug resistance and drug resistance genes in carbapenem-resistant Acinetobacter baumannii

作　　者：陈璐[1] 李凌竹[1] 刘宝[1] 王清青[1] 冷应蓉[1] 查筑红[1] 刘伟[1] 王平[1] 江银辉[1] 游灿青[1] 

机构地区：[1]贵州医科大学附属医院感染管理科,贵州贵阳550004

出　　处：《中华医院感染学杂志》2016年第17期3848-3851,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科技计划基金资助项目(黔科合SY字2013-3176)

摘　　要：目的以医院患者感染标本分离的耐碳青霉烯鲍氏不动杆菌(CR-AB)为对象,检测β-内酰胺酶、氨基糖苷类修饰酶、16SrRNA甲基化酶和磺胺耐药酶共15个耐药基因,探讨耐药性与携带耐药基因的相关关系。方法采用PCR扩增技术对2014年1月-2015年5月收集的119株CR-AB菌株进行检测,检测是否携带OXA-23、TEM、SHV、VEB、CARB、DHA、VIM、IMP、PER、aac(3)-Ⅰ、aac(6′)-Ib、aph(3′)-Ⅰ、armA、sul1、sul2基因。结果 119株CR-AB对15种抗菌药物耐药率均>50.0%,基因检出率:TEM 100.0%、OXA-23 95.8%、armA 92.4%、aac(6′)-Ib 19.3%、aac(3)-I 24.37%、aph(3′)-Ⅰ73.11%、sul1 27.73%、sul2 60.50%、SHV2.52%,VEB、CARB、DHA、IMP、VIM、PER未检出。结论本地CR-AB耐β-内酰胺类抗菌药物的机制可能与TEM酶密切相关,但其作用机制受舒巴坦抑制;SHV、VEB、CARB、DHA、IMP、VIM、PER酶可能在本地CR-AB耐β-内酰胺类抗菌药物机制中的作用不大;armA、aph(3′)-Ⅰ可能是本地CR-AB耐氨基糖苷类抗菌药物的重要元件,耐药是多基因联合作用的结果。OBJECTIVE To detect 15 drug resistance genes ofβ-lactamase,aminoglycoside modifying enzyme,16 S rRNA methylase,and sulfanilamide resistance enzyme in carbapenem-resistant Acinetobacter baumannii（CRAB）strains isolated from specimens of patients with infections and explore the relationship between the drug resistance and the drug resistance genes.METHODS From Jan 2014 to May 2015,a total of 119 strains of CRAB were collected to detect the OXA-23,TEM,SHV,VEB,CARB,DHA,VIM,IMP,PER,aac（3）-Ⅰ,aac（6′）-Ib,aph（3′）-Ⅰ,armA,sul1,and sul2 genes by means of PCR amplification technique.RESULTS The drug resistance rate of the 119 strains of CRAB to 15 antibiotics was more than 50.0%.The detection rates of the drug resistance genes were as the following：TEM 100.0%,OXA-23 95.8%,armA 92.4%,aac（6′）-Ib 19.3%,aac（3）-I24.37%,aph（3′）-Ⅰ 73.11%,sul1 27.73%,sul2 60.50%,SHV2.52%;the VEB,CARB,DHA,IMP,VIM,and PER were not detected.CONCLUSIONTheβ-lactams-resistant mechanism of the CRAB strains may be closely correlated with the TEM,but the mechanism of action is suppressed by sulbactam.The enzymes of SHV,VEB,CARB,DHA,IMP,VIM,and PER may have little effect on theβ-lactam-resistant mechanism of the CRAB strains.In addition,the enzymes of armAand aph（3′）-I may be important elements in the aminoglycosidesresistant CRAB strains,and the drug resistance is caused by the combined effect of multiple genes.

关 键 词：鲍氏不动杆菌 耐药性 耐药基因 

分 类 号：R378[医药卫生—病原生物学]