耐碳青霉烯类鲍氏不动杆菌耐药机制研究  

Research of carbopenem resistant mechanisms in Acinetobacter baumannii

作　　者：侯盼飞 王欣 李秀玲 仇祝强 祝丽晶 HOU Pan-fei WANG Xin LI Xiu-ling QIU Zhu-qiang ZHU Li-jing(Rushan Peoples Hospital, Rushan, Shandong 264500, Chin)

机构地区：[1]乳山市人民医院检验科,山东乳山264500 [2]乳山市人民医院呼吸科,山东乳山264500 [3]乳山市人民医院科教科,山东乳山264500

出　　处：《中华医院感染学杂志》2016年第23期5292-5294,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(2R2014HP061)

摘　　要：目的探讨碳青霉烯酶和主动外排泵在鲍氏不动杆菌对碳青霉烯类抗菌药物耐药中的作用,为临床治疗提供参考依据。方法收集医院2014年临床分离耐碳青霉烯类鲍氏不动杆菌(CRAB)100株,采用琼脂稀释法测定其对临床常用15种抗菌药物的敏感性;PCR检测碳青霉烯酶及外排泵基因的携带情况;随机选取10株CRAB与1株敏感菌,实时荧光定量PCR分析外排泵基因表达量。结果 100株CRAB对多黏菌素B均敏感;PCR扩增结果显示,PER、SHV、TEM阳性率分别为54.00%、32.00%和16.00%;OXA-23阳性率86.00%,adeB、adeJ阳性率分别为55.00%、33.00%;实时荧光定量PCR显示,adeB基因表达量比敏感菌高10倍以上,而adeJ表达量与敏感菌差异无统计学意义。结论 CRAB耐药性较严峻,对碳青霉烯类耐药由携带碳青霉烯酶和主动外排泵共同介导。OBJECTIVE To study the effect of carbopenems and active efflux pumps to carbopenems resistance in Acinetobacter baumannii（CRAB）,so as to provide reference for clinical treatment.METHODS A total of 100 isolates of CRAB were collected from clinical patients in 2014.Antimicrobial susceptibility test was carried out for the sensibility of 15 kinds of antibacterial agents using agar dilution method.Genes of carbapenemases and efflux pumps were amplified by PCR.The expression level of efflux pumps genes were measured by real time PCR for the one sensitive bacteria selected from the 10 strains of CRAD randomly.RESULTS All isolates were sensitive to polymyxin B.The PCR amplification results showed that 54,32 and 16isolates were positive for PER,SHV and TEM,respectively.Also 86 isolates were positive for OXA-23.There were 55 and 33isolates carrying adeBand adeJgenes.The real time PCR showed that the expression level of adeB was ten times higher than sensitive bacteria,and the expression quantity of adeJ had no statistic difference compared with sensitive bacteria.CONCLUSIONThe resistance of A.baumannii in our hospital is serious.Carbapenemases and efflux pumps play an important role as a media in the carbopenems resistance.

关 键 词：耐碳青霉烯类鲍氏不动杆菌 碳青霉烯酶 外排泵 耐药机制 

分 类 号：R378[医药卫生—病原生物学]