鲍曼不动杆菌耐药特征及苯唑西林酶基因分型的研究  

Research of drug resistance characteristics and Oxacilllinase genotypes of Acinetobacter baumannii

作　　者：刘超[1] 魏晔[2] 陆仁飞[1] 赵建华[1] 韩海霞[1] LIU Chao;WEI Ye;LU Renfei;ZHAO Jianhua;HAN Haixia(Department of Clinical Laboratory,the Third People's Hospital of Nantong City,Jiangsu Province,Nantong 226006;Department of Clinical Laboratory,Nantong Maternity and Child Health Care Hospital,Jiangsu Province)

机构地区：[1]江苏省南通市第三人民医院检验科,南通226006 [2]江苏省南通市妇幼保健院检验科

出　　处：《南通大学学报（医学版）》2019年第1期31-35,共5页Journal of Nantong University(Medical sciences)

基　　金：南通市卫生和计划生育委员会科研课题专项(WKZL2018062)

摘　　要：目的:调查南通市第三人民医院鲍曼不动杆菌临床分离株的耐药表型及耐碳青霉烯类鲍曼不动杆菌(carbapenem-resistant Acinetobacter baumannii, CRAB)的苯唑西林酶(Oxacilllinase, OXA酶)基因分型,为临床治疗CRAB的感染和防止CRAB的播散提供帮助。方法 :运用聚合酶链式反应(polymerase chain reaction, PCR)技术鉴定鲍曼不动杆菌,采用仪器法和纸片法测定抗菌药物的最低抑菌浓度(minimum inhibitory concentration, MIC),通过PCR方法检测常见的OXA酶耐药基因型。结果 :43株非重复鲍曼-醋酸钙不动杆菌复合体经PCR法鉴定均为鲍曼不动杆菌,在监测的14种抗菌药物中,耐药率≥85.0%的达10种,仅对头孢哌酮/舒巴坦和米诺环素有较低的耐药率(分别为21.0%和32.6%),对亚胺培南的耐药率高达97.7%;在42株CRAB中,均检测出OXA-51-like和OXA-23-like基因,均未检测出OXA-24-like和OXA-58-like基因。结论 :本院临床分离的鲍曼不动杆菌多重耐药现象严重,携带OXA-23-like基因是我院鲍曼不动杆菌对碳青霉烯类抗生素耐药的重要机制,且存在CRAB的克隆流行。Objective : To investigate the drug-resistant phenotypes of clinical isolates of Acinetobacter baumannii and the Oxacilllinase(OXA enzyme) genotypes of carbapenem-resistant Acinetobacter baumannii(CRAB), it is helpful for clinical treatment of CRAB infection and prevention of spread of CRAB. Methods : The Acinetobacter baumannii isolated from our hospital was identified by polymerase chain reaction(PCR) and the minimum inhibitory concentration(MIC) of antibiotics was determined by instrumental method and paper method. The PCR method detects the genotypes of common OXA enzyme. Results: A total of 43 non-repetitive Acinetobacter baumannii/calco complexes were identified by PCR as Acinetobacter baumannii. Of the 14 antimicrobial agents monitored, 10 were resistant to more than 85.0%, only cefoperazone/sulbactam and minocycline had lower resistance rates(21.0% and 32.6%, respectively), and the resistance rate to imipenem was as high as 97.7%;OXA-51- like and OXA-23- like genes were detected in 42 CRABs. No OXA-24- like and OXA-58- like genes were detected. Conclusion : The multi-drug resistance of Acinetobacter baumannii isolated from clinical in our hospital is very serious. The OXA-23- like gene is an important mechanism for the resistance of Acinetobacter baumannii to carbapenem antibiotics, and our hospital exists the clone spread of CRAB.

关 键 词：鲍曼不动杆菌 耐碳青霉烯类 耐药机制 聚合酶链反应 OXA酶基因 

分 类 号：R378[医药卫生—病原生物学]