多重耐药鲍曼不动杆菌外排泵与外膜蛋白表达水平分析  

Analysis of efflux pump and outer membrane protein of multi⁃drug resistant Acinetobacter baumannii

作　　者：黄育波[1] 周宇麒[1] 郑文争[1] 朱家馨[1] 杨海玲[1] 吴文斌[1] 张天托[1] HUANG Yubo;ZHOU Yuqi;ZHENG Wenzheng;ZHU Jiaxin;YANG Hailing;WU Wenbin;ZHANG Tiantuo(Department of Respiratory and Critical Medicine,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院呼吸与危重症医学科,广州510630

出　　处：《实用医学杂志》2023年第16期2122-2129,共8页The Journal of Practical Medicine

基　　金：广州市科技计划项目(编号:202206010127)。

摘　　要：目的分析鲍曼不动杆菌对常用抗生素的敏感性,检测外排泵基因和外膜蛋白基因的表达水平,探讨上述基因表达与抗生素耐药之间的关系。方法选择下呼吸道标本分离的鲍曼不动杆菌共213株,对其进行菌种鉴定、药敏试验;根据药敏试验将其分为不敏感组(NS组)与敏感组(S组),应用荧光定量PCR检测外排泵基因(adeB、adeJ、adeG、craA、abeM、amvA)、外膜蛋白基因(omp25、omp33-36、carO)的表达水平,比较上述基因在NS组与S组表达水平的差异。结果鲍曼不动杆菌对阿米卡星、亚胺培南不敏感率分别为89.2%、81.2%,对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、庆大霉素等药物的不敏感率均超过92%。adeB基因相对表达量升高(RE≥1)在各抗生素(AMK、IPM、CFP、FEP、TZP、CAZ、SXT、CIP、SCF、CN)NS组的比例高于S组,差异有统计学意义(P<0.05)。外排泵adeB基因mRNA的RE值在上述各抗生素NS组和S组之间差异有统计学意义(P<0.05),NS组adeB基因的RE值平均水平较高。外排泵adeJ、adeG、craA、abeM、amvA基因平均RE水平无升高,且经比较分析差异无统计学意义(P>0.05)。外膜蛋白omp25、omp33-36、carO基因平均RE值均超过1.0,提示相对表达量升高。结论本院鲍曼不动杆菌对多种抗生素耐药率较高。外排泵基因adeB过度表达在本院鲍曼不动杆菌耐药中起着重要作用;其余外排泵基因adeJ、adeG、craA、abeM、amvA和外膜蛋白基因omp25、omp33-36、carO在本研究的多数菌株耐药机制中可能不起作用。Objective To analyze the sensitivity of Acinetobacter baumannii(A.baumannii)to common antibiotics,and to detect the expression level of efflux pump genes and outer membrane protein(OMP)genes and to explore the relationship between the expression of these genes and antibiotic resistance.Methods A total of 213 isolates of multidrug⁃resistant A.baumannii from the lower respiratory tract of inpatients from our hospital were col⁃lected.Susceptibility testing was conducted by K⁃B disk diffusion method.According to the drug sensitivity test,they were divided into non⁃sensitive groups(NS groups)and sensitive groups(S groups).The expression level of efflux pump genes(adeB,adeJ,adeG,craA,abeM,amvA)and OMP genes(omp25,omp33⁃36,carO)were detected by fluorescence quantitative PCR,and the differences of these genes between NS groups and S groups were compared.Results The insensitive rates of A.baumannii to amikacin and imipenem were 89.2%and 81.2%respec⁃tively,and the insensitive rates to piperacillin/tazobactam,cefoperazone/sulbactam and gentamicin were more than 92%.The distribution of increased relative expression of adeB gene(RE≥1)in NS and S groups of antibiotics(AMK,IPM,CFP,FEP,TZP,CAZ,SXT,CIP,SCF,CN)was analyzed respectively.The results showed that the proportion of RE≥1 in most antibiotic NS groups was significantly higher than that in S groups,suggesting that the overexpression of adeB was closely related to the above⁃mentioned antibiotic resistance.The RE values of adeB gene mRNA of efflux pump were significantly different in the following antibiotics(AMK,IPM,CFP,FEP,TZP,CAZ,CIP,SCF,CN)between NS groups and S groups respectively.The RE values of efflux pump genes(adeJ,adeG,craA,abeM and amvA)in the two groups had no elevation,and there was no statistical difference between the two groups by comparative analysis.The average RE values of OMP genes(omp25,omp33⁃36,carO)were all more than 1.0,indicating an increasing of relative expression.Conclusion The A.baumannii is highly resistant to many kinds of

关 键 词：鲍曼不动杆菌 耐药 外排泵 外膜蛋白 

分 类 号：R378[医药卫生—病原生物学]