消化科住院患者医院感染鲍曼不动杆菌外排泵系统机制研究及耐消毒剂基因检测分析  

A study of the mechanism of the efflux pump system and an analysis of disinfectant resistance genes of Acinetobacter baumannii infecting patients in Gastroenterology

作　　者：刘红丹[1] 徐文思[1] 张慧宇[1] 张博[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院消化一科,黑龙江齐齐哈尔161000

出　　处：《中国病原生物学杂志》2016年第10期943-946,共4页Journal of Pathogen Biology

摘　　要：目的分析消化科患者感染鲍曼不动杆菌的外排泵系统机制及耐消毒剂基因分布情况,为患者的临床治疗及细菌耐药性发展的控制提供指导。方法分离自消化内科患者临床标本的鲍曼不动杆菌132株,采用K-B法进行耐药性分析。纯培养后挑取单菌落,加入到含有蛋白酶K溶液的离心管中,经水浴后离心,以设计的引物PCR扩增目的基因片段,观察耐药基因携带情况。结果 132株鲍曼不动杆菌中分离自痰液占71.97%、伤口分泌物占12.88%、脓液占6.82%、尿液占3.03%、其他标本占5.30%。K-B法测定132株鲍曼不动杆菌对阿米卡星、链霉素、庆大霉素、米诺环素、头孢吡肟、头孢噻肟、亚胺培南、美罗培南的耐药率分别为11.36%、55.30%、42.42%、34.85%、53.79%、61.36%、5.30%和10.61%。PCR检测鲍曼不动杆菌分离株的adeB基因大小为541bp,adeJ基因为453bp,abeM基因为781bp,adeR基因为447bp,adeS基因为544bp,检出率分别为38.64%、79.55%、40.91%、32.58%和51.52%;PCR检测鲍曼不动杆菌的耐消毒剂基因qacE△1基因大小为300bp,检出率为53.03%。结论消化内科患者感染的鲍曼不动杆菌对常用治疗药物均产生了一定程度的耐药性,这可能与菌株的外排泵系统基因及耐消毒剂基因携带率较高有一定关系。因此,及时进行细菌病原学及耐药性监测对于患者疾病治疗及控制细菌耐药性发展具有重要意义。Objectives To analyze the mechanism of the efflux pump system and to analyze the disinfectant resistance genes of Acinetobacter baumannii infecting patients in Gastroenterology in order to guide the clinical treatment of patients and the control of the development of drug resistance. Methods Samples were collected from patients in Gastroenterology,and 132 strains of A.baumannii were isolated and identified.The drug resistance of the strains was analyzed using the K-B method.A single colony was selected and inserted in an Ep tube containing aproteinase K solution.After a bath and centrifugation,primers were designed for amplification of target gene fragments with PCR,and the state of drug resistance genes was determined. Results In total,132 strains of A.baumannii were isolated from 274 patients in Gastroenterology in Hospital A.A.baumannii was found in sputum in 71.97% of specimens,in wound secretions in12.88%,in pus in 6.82%,in urine 3.03%,and in other specimens in 5.30%.The drug resistance of the clinical isolates of A.baumannii was analyzed using the K-B method.The 132 strains were resistant to amikacin at a rate of11.36%,to streptomycin at a rate of 55.30%,to gentamicin at a rate of 42.42%,to minocycline at a rate of 34.85%,to cefepime at a rate of 53.79%,to cefotaxime at a rate of 61.36%,to imipenem at a rate of 5.30%,and to meropenem at a rate of10.61%.Findings indicated that A.baumannii infecting patients in Gastroenterology was somewhat resistant to common antibacterials,and it was most resistant to cefotaxime（61.36%）.PCR revealed that the adeB gene of A.baumannii was541 bp in length,the adeJ gene was 453 bp in length,the abeM gene was 81 bp in length,the adeR gene was 447 bp in length,and the adeS gene was 544 bp in length.adeB was detected in 38.64% of the isolates,adeJ was detected in79.55%,abeM was detected in 40.91%,adeR was detected in 32.58%,and adeS was detected in 51.52%.qacE△1is a disinfectant resistance gene.PCR revealed that the qacE△1gene was 300 bp in length,and qacE？1 was detected

关 键 词：消化科 鲍曼不动杆菌 外排泵系统 耐消毒剂基因 

分 类 号：R382.31[医药卫生—医学寄生虫学]