临床分离鲍曼不动杆菌耐药表型和质粒介导喹诺酮类耐药基因研究  

Study on drug-resistant phonotype and plasmid-mediated quinolone resistance genes in Acinetobacter baumannii isolates

作　　者：袁星[1] 苏琰[1] 胥振国[1] 李自生[2] YUAN Xing;SU Yan;XU Zhenguo;LI Zisheng(Department of Medicine School,Hefei Technical College,Hefei 238000,Anhui,China;Department of Radioimmunology,the Chaohu Affiliated Hospital of Anhui Medical University,Hefei 238000,Anhui,China)

机构地区：[1]合肥职业技术学院医学院,安徽合肥238000 [2]安徽医科大学附属巢湖医院放射免疫科,安徽合肥238000

出　　处：《中国临床药理学与治疗学》2021年第10期1111-1117,共7页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：安徽省高水平高职专业-医学检验技术(2018ylzy146);微生物检验大规模在线开放课程示范项目(2019dgmkc005);安徽省教育厅重点科研项目-大肠杆菌-酵母菌穿梭克隆载体的构建及应用研究(KJ2019A1125);安徽省教育厅重点科研项目-巢湖水体微生物群落结构及多样性的研究(KJ2018A0831)。

摘　　要：目的:对医院分离出的鲍曼不动杆菌耐药谱进行调查,探求鲍曼不动杆菌中质粒介导对喹诺酮类药物耐药基因(PMQR)携带情况,给临床感染性疾病治疗提供参考。方法:采用VITEKT-2 compact全自动细菌鉴定及药敏系统对菌株进行鉴定和药敏检测,采用PCR法检测细菌是否携带PMQR基因(qnrA、B、C、D、S、aac(6')-Ib和qepA),随机选取每种耐药基因的PCR产物进行测序分析。病原菌的药敏结果采用WHONET 5.6软件分析。结果:近两年来从临床标本中一共检出152株鲍曼不动杆菌,药敏结果显示鲍曼不动杆菌对喹诺酮类和其他抗菌药物的耐药性有逐年递增之势。PCR检测结果显示29.6%(45/152)菌株携带aac(6')-Ib,1.3%(2/152)菌株携带qnrB,质粒上的qnrA、C、D、S和外排泵qepA基因产物并未检测出。结论:本地区鲍曼不动杆菌对临床常用抗菌药物的耐药性强,PMQR携带率较低。AIM:To investigate drug resistance of Acinetobacter baumannii strains isolated in the hospital from 2018 to 2019,and explore plasmid-mediated delivery of quinolones resistance genes(PMQR)in Acinetobacter baumannii,to provide references for the clinical therapy of infections and to analysis the genetic mechanisms of resistance by aid of molecular methods.METHODS:Bacteria were identified by VITEK-2 compact System,the results of antibiotics susceptibility test was determined by using microdilution method MIC.We amplified genes of qnrA,B,C,D,S,aac(6')-Ib and qepA on plasmid by PCR,and PCR products of each resistant gene for sequencing analysis were random selected.We analyzed the results of antibiotics susceptibility of 152 clinical isolates based on WHONET 5.6 software.RESULTS:In the past two years,152 strains of Acinetobacter baumannii have been detected from clinical specimens.The antibiotics resistance rate of Acinetobacter baumannii isolates was an increasing trend year by year.PCR indicated that some strains of Acinetobacter baumannii have products of aac(6')-Ib and qnrB gene,29.6%(45/152)strains carrying aac(6')-Ib and 1.3%(2/152)strains carrying qnrB;there were no products of qnrA,C,D,S and qepA genes on plasmid.CONCLUSION:The current drug-resistance rate among Acinetobacter baumannii strains in Hefei to common antibiotics is high,and PMQR carrying rate is low.

关 键 词：鲍曼不动杆菌 抗菌药物 质粒介导 喹诺酮 基因 

分 类 号：R691.3[医药卫生—泌尿科学] R969.3[医药卫生—外科学]