鲍曼不动杆菌耐药性与毒力基因阳性模式相关性分析  

Analysis for correlation between drug resistance and positive pattern of virulence genes in Acinetobacter baumannii

作　　者：张琴 王玉月[1] 史伟峰[1] ZHANG Qin;WANG Yuyue;SHI Weifeng(Department of Laboratory Medicine,the Third Affiliated Hospital of Soochow University,Changzhou 213003,Jiangsu,China)

机构地区：[1]常州市第一人民医院检验科

出　　处：《临床检验杂志》2019年第10期784-788,共5页Chinese Journal of Clinical Laboratory Science

基　　金：国家自然科学基金(81572052);江苏省自然科学基金(BK20151178)

摘　　要：目的调查鲍曼不动杆菌耐药性及毒力基因阳性情况,分析鲍曼不动杆菌耐药性与毒力基因阳性模式的关系。方法收集67株鲍曼不动杆菌,用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)技术对鲍曼不动杆菌进行鉴定,采用比浊法及氧化还原指示剂显色法进行药敏试验。聚类分析了解鲍曼不动杆菌同源性。PCR检测细菌外膜蛋白(ompA)、生物膜形成(adeH、csuA、pgaA)、铁摄取系统(basJ)、磷脂酶D(plcD)、荚膜阳性表型(ptk)和群体感应系统调节(abaI)8种毒力基因,并测序验证。分析鲍曼不动杆菌毒力基因与其耐药性关系。结果毒力基因ompA、adeH、csuA、pgaA、abaI、basJ、ptk和plcD的检出率分别为94%、100%、94%、99%、93%、96%、82%和99%。67株鲍曼不动杆菌中,同时检出3种基因的1株(1.5%)、5种基因的2株(3.0%)、6种基因的2株(3.0%)、7种基因14株(20.9%)和8种基因的48株(71.6%)。8种毒力基因阳性48株,多黏菌素耐药率仅为2.1%,四环素为58.2%,哌拉西林等其余13种的抗菌药物耐药率>80%;7种毒力基因阳性14株,对除多黏菌素、四环素以外的抗菌药物耐药率>78%。聚类分析结果显示,67株鲍曼不动杆菌共分为A、B 2个基因型,A型41株,B型26株。A型可分为A1(27株)、A22个亚型(14株),A1亚型主要来自神经外科(7株)、ICU(5株)和呼吸科(3株)等科室,A2亚型则主要来自呼吸科(3株)、心胸外科(3株)、ICU(2株)、神经外科(2株)等科室。B型可分为B1亚型(19株)、B2亚型(7株),B1亚型主要来自ICU(7株)、神经外科(4株)和呼吸科(3株)等科室,B2亚型主要来自ICU(2株)、呼吸科(3株)等科室。结论我院鲍曼不动杆菌可能存在交叉感染。鲍曼不动杆菌的耐药性与毒力基因阳性模式无相关性。Objective To investigate the drug resistance and positive virulence genes of Acinetobacter baumannii(A.baumannii)and analyze the correlation between drug resistance and the positive pattern of virulence genes.Methods A total of 67 strains of A.baumannii were collected and identified by matrix assisted laser desorption ionization time of flight mass spectrometry technology(MALDI-TOF MS).Drug susceptibility tests were carried out by turbidimetric and redox indicator method.The homology of A.baumannii stains was explored by cluster analysis.The 8 virulence genes including bacterial outer membrane protein(ompA),biofilm formation(adeH,csuA,pgaA),iron uptake system(basJ),phospholipase D(plcD),capsular positive phenotype(ptk)and regulation of quorum sensing system(abaI)were amplified by PCR and sequenced.The correlation between virulence genes and drug resistance in the 67 strains of A.baumannii was investigated.Results The positive rates of virulence genes ompA,adeH,csuA,pgaA,abaI,basJ,ptk and plcD were 94%,100%,94%,99%,93%,96%,82% and 99%,respectively.Among the 67 strains of A.baumannii,3 genes were simultaneously detectable in 1 strain(1.5%),5 genes were positive in 2 strains(3.0%),6 genes were positive in 2 strains(3.0%),7 genes were positive in 14 strains(20.9%)and all the 8 genes were positive in 48 strains(71.6%).Among the 48 strains with 8 positive virulence genes,the drug resistance rate of polymyxin was only 2.1%,but tetracycline was 58.2%,piperacillin and other 13 antibiotics was more than 80%.The 14 strains with 7 positive virulence genes showed more than 78% of resistance rate for all the tested antibiotics except for tetracycline and polymyxin.Cluster analysis showed that the 67 strains of A.baumannii were divided into 2 genotypes:A(41 strains)and B(26 strains).The 41 strains of A type were divided into A1(27 strains)and A2(14 strains)subtypes.The strains of A1 subtype were mainly from neurosurgery department(7 strains),ICU(5 strains)and pneumology department(3 strains).The strains of A2 subtype were mainl

关 键 词：鲍曼不动杆菌 毒力基因 序列分析 

分 类 号：R446.5[医药卫生—诊断学]