淋巴造血系统恶性肿瘤患者鲍曼不动杆菌耐药性分析  

Pathogenic analysis of Acinetobacter baumannii infection in patients with lymphohematopoietic malignancies

作　　者：郝秀乔[1] 宋博宁 冯蕾[1] 杨向丹 牛秀然[1] HAO Xiu-qiao;SONG Bo-ning;FENG Lei;YANG Xiang-dan;NIU Xiu-ran(The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院,河北石家庄050011

出　　处：《中国病原生物学杂志》2022年第9期1095-1098,1102,共5页Journal of Pathogen Biology

基　　金：河北省2020年度医学科学研究课题(No.20201126)。

摘　　要：目的分析淋巴造血系统恶性肿瘤患者鲍曼不动杆菌耐药情况,为预防和治疗提供有力依据。方法收集淋巴造血系统恶性肿瘤患者感染标本,全自动微生物鉴定系统进行初步鉴定。采用倍比稀释法检测鲍曼不动杆菌对临床常用药物的耐药性。PCR对鲍曼不动杆菌进行确认,对其碳青霉烯类和氨基糖苷类常见耐药基因进行检测。结果34份样本经微生物鉴定分析仪初步鉴定为鲍曼不动杆菌,经16S rRNA检测并进行序列比对分析,31份样本菌株鉴定为鲍曼不动杆菌,4份样本菌株为醋酸钙不动杆菌。鲍曼不动杆菌对哌拉西林、头孢噻肟、头孢他啶、头孢吡肟、庆大霉素、妥布霉素、阿米卡星、环丙沙星、加替沙星、复方新诺明、哌拉西林/他唑巴坦、美罗培南、亚胺培南、替加环素、米诺环素和多粘菌素B耐药率为87.10%、77.42%、51.61%、48.39%、58.06%、61.29%、35.48%、48.39%、29.03%、54.84%、45.16%、41.94%、41.94%、32.26%、19.35%和0.00%。碳青霉烯类耐药基因检测结果显示bla_(TEM)、bla_(IMP)、bla_(OXA-23)和bla_(OXA-51)检出率分别为:48.39%、16.13%、9.68%和61.29%。氨基糖苷类耐药基因检测结果显示ant(3″)-I、aac(3)-I、aac(6′)-Ib和aph(3′)-I检出率分别为:54.84%、35.48%、25.81%和19.35%。结论鲍曼不动杆菌对多数抗生素具有较强耐药性,临床治疗时应重视药物的选择。Objective The etiological analysis of Acinetobacter baumannii infection in patients with lymphohematopoietic malignancies provides a strong basis for prevention and treatment.Methods The infection samples of patients with malignant tumors of lymphohematopoietic system were collected and preliminarily identified by automatic microbial identification system.Multiple dilution method was used to detect the resistance of A.baumannii to commonly used clinical drugs.A.baumannii was confirmed,and the common resistance genes of carbapenems and aminoglycosides were detected by PCR.Results 34 samples were preliminarily identified as A.baumannii by microbial identification analyzer.After 16S rRNA detection and sequence comparison analysis,31 sample strains were A.baumannii,and 4 sample strains were Acinetobacter calcium acetate.The resistance rates of A.baumannii to piperacillin,cefotaxime,ceftazidime,cefepime,gentamicin,tobramycin,amikacin,ciprofloxacin,gatifloxacin,cotrimoxazole,piperacillin/tazobactam,meropenem,imipenem,tegacyclin,minocycline and polymyxin B were 87.10%,77.42%,51.61%,48.39%,58.06%,61.29%,35.48%,48.39%,29.03%,54.84%,45.16%,41.94%41.94%,32.26%,19.35%and 0.00%.The detection results of carbapenem resistant genes showed that the detection rates of bla_(TEM),bla_(IMP),bla_(OXA-23) and bla_(OXA-51) were 48.39%,16.13%,9.68%and 61.29%respectively.The detection results of aminoglycoside resistance genes showed that the detection rates of ant(3″)-I,aac(3)-I,aac(6′)-Ib and aph(3′)-I were 54.84%,35.48%,25.81%and 19.35%respectively.Conclusion A.baumannii has strong resistance to most antibiotics,so we should pay attention to the choice of drugs in clinical treatment.

关 键 词：淋巴造血系统恶性肿瘤 鲍曼不动杆菌 病原学分析 

分 类 号：R378[医药卫生—病原生物学]