临床分离不动杆菌对耐碳青霉烯类耐药表型与基因分型特征研究  

Study on drug resistance phenotypes and genotyping of clinical carbapenem-resistant Acinetobacter

作　　者：刘琳[1,2] 陈勇 韩黎 吴安华 李春辉 邱广斌 翟如波[4] 邓安梅[5] 黄晓春[5] 府伟灵[6] 刘智勇[6] 邹自英[7] LIU Lin;CHEN Yong;HAN Li;WU An - hua;LI Chun - hui;QIU Guang - bin;QU Ru - bo;DENG An - mei;HUANG Xiao - chun;FU Wei - ling;LIU Zhi - yongs;ZOU Zi - ying(Academy of Military Medical Sciences,Academy of Military Sciences,Beijing 100039;Institute of Disease Control and Prevention of PLA;Xiangya Hospital, Central South University;No. 202 Hospital of PLA;Changhai Hospital;South- west Hospital;Chengdu Military Aera Command General Hospital,China)

机构地区：[1]军事科学院军事医学研究院,北京100039 [2]解放军疾病预防控制所 [3]中南大学湘雅医院 [4]解放军第202医院 [5]上海长海医院 [6]西南医院 [7]成都军区总医院

出　　处：《中国消毒学杂志》2018年第6期423-427,共5页Chinese Journal of Disinfection

基　　金：国家传染病重大专项(2018ZX10303402);北京市自然科学基金(7172157)

摘　　要：目的研究携带不同碳青霉烯酶编码基因不动杆菌的耐药表型与基因分型特征。方法采用药敏试验和RepPCR技术,对临床分离不动杆菌进行耐药分型检测和同源性分析。结果检出16株携带blaOXA-72基因与16株携带blaOXA-23-like基因的鲍曼不动杆菌耐药表型相似、基因分型一致。该16株鲍曼不动杆菌对哌拉西林、哌拉西林他唑巴坦、阿米卡星、庆大霉素、环丙沙星、左氧氟沙星等抗菌药物的耐药率均高于携带blaNDM-1基因的不动杆菌。8株携带blaNDM-1基因的不动杆菌分为5个Rep-PCR型,且与携带blaOXA-72或blaOXA-23-like基因的不动杆菌基因分型差异较大。RepPCR与MLST分型的结果相符。结论产OXA类与NDM类不动杆菌菌株的耐药表型与基因分型的差异较大。具有相同耐药机制不动杆菌在不同医院的克隆传播可能是我国碳青霉烯类耐药不动杆菌广泛播散的主要原因。Objective To explore the drug resistant phenotype and genotyping characteristics of clinical carbapenem-resistant Acinetobacter. Methods Drug susceptibility test and Rep-PCR technology were used to analyze the drug resistant phenotype and genetype relationship. Results 16 blaOXA-72 gene-positive A. Baumannii strains and 16 blaOXA-23-likegene-positve A. baumannii strains showed similar resistance phenotypes and identical genotype. The resistance rates to piperacillin,piperacillin-tazobactam,amikacin,gentamicin,ciprofloxacin,levofloxacin of these strains were higher than those of Acinetobacter carrying the blaNDM-1 gene. Eight Acinetobacter strains carrying the blaNDM-1 gene were divided into five Rep-PCR types,and the genotypes of the eight strains were different from those carrying the blaOXA-72 or blaOXA-23-likegenes. Rep-PCR was consistent with the results of MLST typing. Conclusion The resistance phenotypic and genotyping of OXA-producing strains and NDM-producing Acinetobacter strains are quite different. Clonal spread of Acinetobacter with different resistance mechanisms in different hospitals may be the main reason for the widespread dissemination of carbapenem-resistant Acinetobacter in China.

关 键 词：鲍曼不动杆菌 碳青霉烯类药物 耐药 基因分型 

分 类 号：R378[医药卫生—病原生物学]