碳青霉烯酶在亚胺培南耐药鲍曼不动杆菌中的作用  

Role of carbapenem in imipenem resistant Acinetobacter Baumannii

作　　者：侯盼飞 祝丽晶 潘艳[1] HOU Pan-fei;ZHU Li-jing;PAN Yan(Department of Clinical Laboratory,Lianshui County People＇s Hospital,Lianshui 223400,China)

机构地区：[1]涟水县人民医院检验科,江苏涟水223400

出　　处：《中国实验诊断学》2018年第11期1938-1941,共4页Chinese Journal of Laboratory Diagnosis

基　　金：山东省自然科学基金资助项目(ZR2014HP061)

摘　　要：目的探讨碳青霉烯酶在鲍曼不动杆菌对亚胺培南耐药中的作用,为临床合理用药及控制医院感染提供依据。方法收集临床分离非重复鲍曼不动杆菌100株,其中亚胺培南耐药和敏感各50株,琼脂稀释法检测上述细菌对18种抗菌药物的敏感性,改良霍奇(Hodge)试验进行碳青霉烯酶表型检测。PCR技术检测10种碳青霉烯酶基因携带情况。结果所有菌株对替加环素、多粘菌素B均敏感,亚胺培南耐药菌除对头孢哌酮/舒巴坦(32%)和米诺环素(30%)耐药率低外,对其他抗菌药物耐药率均较高,而亚胺培南敏感菌对多数抗生素均较敏感。Hodge试验亚胺培南耐药菌阳性率82%,敏感菌全部阴性。PCR扩增显示亚胺培南耐药菌中SHV、PER、TEM、OXA-23阳性率分别为70%、56%、34%和90%,与敏感菌相比差异有统计学意义(P<0.05),未检测到KPC、NDM、IMP、VIM、SIM和OXA-24基因。结论亚胺培南耐药鲍曼不动杆菌耐药情况严峻,碳青霉烯酶在耐药中发挥重要作用。Objective To investigate the role of carbapenem in imipenem resistant Acinetobacter baumannii,and to provide basis for rational drug use and control of nosocomial infection.Methods 100strains of non-repeated Acinetobacter baumannii were collected,including 50isolates of imipenem resistance（IRAB）and 50of sensitive（ISAB）.The agar dilution method was used to detect the sensitivity to 18kinds of antibiotics.The modified Hodge test was used to detect the phenotyping of carbapenem.PCR technology was used to detect the 10kinds of carbapenem gene.Results All isolates were sensitive to tigecycline and polymyxin B.IRAB were highly resistant to other antibiotics except for Cefoperazone/sulbactam（32%）and minocycline（30%）.While ISAB were sensitive to most antibiotics.The positive rate of IRAB in Hodge was 82%,and all ISAB were negative.PCR amplification showed that the positive rates of SHV,PER,TEM and OXA-23in IRAB were 70%,56%,34%and 90%,respectively.The differences were statistically significant compared with those of ISAB（P〈0.05）.KPC,NDM,IMP,VIM,SIM and OXA-24genes were not detected.Conclusion The drug resistance of IRAB is serious,and carbapenems play an important role in drug resistance.

关 键 词：碳青霉烯酶 鲍曼不动杆菌 耐药性 耐药机制 

分 类 号：R446.1[医药卫生—诊断学]