亚胺培南耐药的鲍氏不动杆菌OXA、AdeABC、CarO基因及生物膜的研究  

Investigation of OXA,AdeABC,CarO genes and biofilm in imipenem-resistant Acinetobacter baumannii strains

作　　者：潘红超[1] 商安全 张康见 刘晓明[1,3] 王利新[1,3] 刘红军 赖有国 魏军[1,3] 

机构地区：[1]宁夏医科大学临床医学院,宁夏银川750004 [2]盐城市第六人民医院检验医学科,江苏盐城224005 [3]宁夏医科大学总医院医学实验中心,宁夏银川750004 [4]广州达安临床检验中心,广东广州510700

出　　处：《中华医院感染学杂志》2016年第20期4572-4575,共4页Chinese Journal of Nosocomiology

基　　金：宁夏自治区教育厅重点项目(NGY2014070);宁夏自治区教育厅研究生教育创新计划(NXYC201511);宁夏自治区临床病原微生物重点实验室开放课题(LCPM201502-1)

摘　　要：目的通过对临床分离的亚胺培南耐药和敏感鲍氏不动杆菌OXA、AdeABC、CarO基因及生物膜形成分布进行调查,进一步分析鲍氏不动杆菌对亚胺培南的耐药机制。方法对2014年11月-2015年10月医院临床分离106株亚胺培南耐药和102株亚胺培南敏感的鲍氏不动杆菌运用PCR技术分别进行OXA、AdeABC、CarO基因的检测;采用96孔微量滴定板法体外构建生物膜并对其进行定量。结果在所有检测菌株中亚胺培南耐药和敏感菌株OXA-23检出率分别为99.1%和2.9%,差异有统计学意义(P<0.05);OXA-24基因仅在1株耐药菌株中检出;OXA-51基因均为阳性,而OXA-58基因均为阴性;而AdeABC基因在耐药和敏感菌株分布具有较大差异。结论 OXA-23基因是最流行的基因,是医院耐亚胺培南鲍氏不动杆菌的最主要OXA亚型;临床鲍氏不动杆菌所引发的感染多数与生物膜的形成有关,对医院临床治疗提供了有效的科学依据。OBJECTIVE To investigate the distributions of OXA, AdeABC, CarO genes and biofilm in clinical imi- penem-resistant and imipenem-sensitive Acinetobacter baumannii isolates, so as to further explore the imipenem- resistant mechanism. METHODS A total of 106 strains of imipenem-resistant and 102 strains of imipenem-sensitive clinical AB strains were isolated from the General Hospital of Ningxia Medical University from Nov. 2014 to Oct. 2015. The drug-resistant genes OXA, AdeABC, and CarO were detected with PCR technology,and biofilm for- mation and quantitative experiment were carried out with microtiter plate method. RESULTS The detection rates of OXA-23 gene were respectively 99.1% and 2.9 % in imipenem-resistant and imipenem-sensitive strains, with sig- nificant difference（P〈0.05）. The OXA-24 gene was found in one imipenem-resistant isolate. The OXA-51 gene was detected in all tested clinical isolates, while the 0XA-58 gene was not detected in all examined strains. The distribution of AdeABC efflux pump genes showed a significant variation between resistant and sensitive isolates. CONCLUSION The OXA-23 gene was the most prevalent gene in these imipenem-resistant strains, and was the most important OXA subtype of imipenem-resistant strains in hospital. The majority of these examined A. bau- mannii infection in clinic was related to the formation of biofilm, which can provide scientific basis for clinical treatment.

关 键 词：鲍氏不动杆菌 OXA AdeABC CarO 生物膜 

分 类 号：R378.99[医药卫生—病原生物学]