耐碳青霉烯类多重耐药鲍曼不动杆菌的毒力特征研究  

Virulence characteristics of carbapenem resistant-Acinetobacter baumannii

作　　者：赵祝香 李裕军 潘楚芝[2] 周泉 魏树全 钟维农 赵子文 陈惠玲 

机构地区：[1]华南理工大学附属第二医院广州医科大学附属市一人民医院呼吸内科,广州510630 [2]中山大学附属第三医院肝胆外科

出　　处：《中华生物医学工程杂志》2017年第3期199-203,共5页Chinese Journal of Biomedical Engineering

基　　金：广东省科技厅项目（20138021800069）;广州市医药卫生科技项目（20151A011004）

摘　　要：目的 了解耐碳青霉烯类鲍曼不动杆菌毒力因子携带状况,评估其致病力的强弱.方法 2016年1月-12月广州市第一人民医院医院感染患者标本中分离93株多重耐药性鲍曼不动杆菌,其中碳青霉烯类耐药菌株75株,碳青霉烯类敏感菌株18株,运动平板法进行蹭行运动检测、试管法测定菌株内明胶酶活性、结晶紫染色法定量分析生物被膜形成能力、微量法进行D-甘露糖抵抗的红细胞凝集试验.结果 耐碳青霉烯类鲍曼不动杆菌被膜形成率为70.7％（60/93）,而敏感菌株被膜形成率为38.9％（7/18）（P〈0.05）;多重耐药鲍曼不动杆菌的平均蹭行直径为（5.82±2.67）mm;耐碳青霉烯类鲍曼不动杆菌平均蹭行直径（5.32±1.65）mm,碳青霉烯类敏感菌株平均蹭行直径（7.89±4.75）mm（P〈0.05）;3株耐碳青霉烯类鲍曼不动杆菌检测有明胶酶活性,其余均为阴性;红细胞凝集与抑制试验发现,无D-甘露糖存在条件下,90株鲍曼不动杆菌菌株与AB型红细胞发生凝集,89株与O型红细胞发生凝集;有D-甘露糖存在条件下,83株与AB型红细胞发生凝集,84株与O型红细胞发生凝集,耐碳青霉烯类株与敏感菌株红细胞凝集与抑制试验差异无统计学意义.结论 多重耐药鲍曼不动杆菌具有一定致病力,碳青霉烯类敏感菌株虽然具有更强的毒力,但耐碳青霉烯类菌株更易形成生物被膜,适应能力更强.这些病原学特征可能是临床上多重耐药鲍曼不动杆菌引起感染重要依据.Objective To investigate the carriage status of virulence factors of carbapenem-resistant Acinetobacter baumannii,and to evaluate its levels of pathogenicity. Methods Ninety-three strains of multi-drug resistant Acinetobacter baumanni were isolated from the specimens of infected patients , who were hospitalized in Guangzhou First Municipal People＇s Hospital between January 2016 and December 2016,including 75 carbapenem-resistant strains and 18 carbapenem-susceptible strains. The switching motility was examined by plate method. The gelatinase activity in the strains was determined by test tube method. The biofilm formation was determined by quantitative analysis of crystal violet staining method. The D-mannose-resistant hemagglutination was determined by micromethod. Results The biofilm formation rate of carbapenem-resistant Acinetobacter baumannii was 70.7%（60/93）,while the biofilm formation rate of the susceptible strains was 38.9%（7/18）（P〈0.05）. The average diameter of switching motility of multi-drug resistant Acinetobacter baumanni was （5.82 ± 2.67） mm. The average diameter of switching motility of carbapenem-resistant Acinetobacter baumannii was（5.32±1.65）mm,and the average diameter of switching motility of carbapenem-susceptible strains was（7.89 ± 4.75）mm（P〈0.05）. The examination showed that there was gelatinase activity in 3 carbapenem-resistant Acinetobacter baumannii strains,and the others were all negative. The findings of the hemagglutination-inhibition test showed that 90 Acinetobacter baumannii strains were agglutinated with AB-type erythrocytes,and 89 strains were agglutinated with O-type erythrocytes under the absence of D-mannose;83 strains were agglutinated with AB-type erythrocytes,and 84 strains were agglutinated with O-type erythrocytes under the presence of D-mannose. There was no statistically significant difference in the hemagglutination-inhibition test between carbapenem-resistant strains and susceptible strains. Conclusion Multi-drug resistant Acineto

关 键 词：鲍氏不动杆菌 多药耐药相关蛋白质类 毒力因子 感染 

分 类 号：R446.5[医药卫生—诊断学]