四川省简阳市院感鲍曼不动杆菌耐药性及同源性溯源研究  

Value of drug resistance and homology of Acinetobacter baumannii in tracing the source of nosocomial infection in Jianyang, Sichuan

作　　者：毛炜[1] 黄春华[1] 方英[2] 吕宇 MAO Wei;HUANG Chun-hua;FANG Ying;LYU Yu(Department of Laboratory Medicine,Jianyang People's Hospital,Jianyang Sichuan 641400,China;Department of Hospital Infection Management,Jianyang People'sHospital,Jianyang Sichuan 641400,China;Department of Hospital Infection Management,Sichuan Academy ofMedical Sciences&Sichuan Provincial People's Hospital,Chengdu Sichuan 610072,China)

机构地区：[1]简阳市人民医院检验科,四川简阳641400 [2]简阳市人民医院感染管理科,四川简阳641400 [3]四川省医学科学院,四川省人民医院感染控制中心,四川成都610072

出　　处：《中国热带医学》2023年第1期44-48,共5页China Tropical Medicine

基　　金：四川省卫生健康委员会科研基金(No.18PJ571)。

摘　　要：目的分析临床患者和临床环境分离的鲍曼不动杆菌药敏和耐碳青霉烯酶基因携带情况,探讨各菌株间的同源性,为控制医院感染提供数据依据。方法收集2019年1月—2020年8月分离来源于临床患者和临床环境共38株鲍曼不动杆菌,采用最低抑菌浓度法检测抗菌药物敏感性,采用聚合酶链式反应检测相关耐药基因,肠杆菌基因重复一致序列指纹图谱进行菌株同源性分析。结果34株来源于临床患者的鲍曼不动杆菌和4株环境中分离的鲍曼不动杆菌均携带bla_(OXA-51)和bla_(IMP)耐药基因,均不携带bla_(VIM)基因,32株鲍曼不动杆菌携带bla_(OXA-23)基因,28株携带bla_(TEM)基因,7株携带bla_(OXA-58)基因。经聚类分析后,38株鲍曼不动杆菌分为7个基因型(分别用A、B、C、D、E、F、G表示),聚类E和聚类G为主要簇型,分别包含12株(12/38,31.6%)和18株(18/38,47.4%),为主要流行克隆株。结论临床患者和环境中分离的鲍曼不动杆菌耐药差异较大,携带的耐药基因差异也较大。患者与环境中的鲍曼不动杆菌分属于不同克隆株,无直接相关关系。同时,感染同类簇型鲍曼不动杆菌的临床患者之间也无明显相关性。Objective To analyze the drug sensitivity and the carrying of carbapenem resistant gene of Acinetobacter baumannii isolated from clinical patients and clinical objects,and analyze the homology of strains to provide support for the control of nosocomial infection.Methods A total of 38 strains of Acinetobacter baumannii isolated from patients and clinical objects surface were collected from January 2019 to August 2020.The antimicrobial susceptibility was tested by the minimum inhibitory concentration method.In addition,the resistance related genes were detected by polymerase chain reaction method,and homology analysis was performed by enterobacterial repetitive Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR).Results All 34 strains of Acinetobacter baumannii isolated from Clinical patients and 4 strains isolated from clinical objects carried bla_(OXA-51)and imp resistance genes,neither of them carried bla_(VIM)gene.32 Acinetobacter baumannii carrying bla_(OXA-23)gene,28 strains carrying bla_(TEM)gene,7 strains carrying blaOXA-58gene.After cluster analysis,38Acinetobacter baumannii isolates were classified into 7 genotypes (expressed A,B,C,D,E,F,G),and cluster E and cluster G were the main clusters,containing 12 strains (12/38,31.6%) and 18 strains (18/38,47.4%),respectively,as the main prevalent clonal strains.Conclusions Acinetobacter baumanniiisolated from different sources have the significant differences in drug resistance and carry different resistance genes.There is no direct correlation between patients and environmental isolates of Acinetobacter baumannii belonging to different clonal strains.Also,there aren’t significant correlation between clinical patients infected with Acinetobacter baumannii.

关 键 词：鲍曼不动杆菌 耐药基因 凝胶电泳 同源性 

分 类 号：R237.99[医药卫生—中医学]