目的分析消化科患者感染鲍曼不动杆菌的外排泵系统机制及耐消毒剂基因分布情况,为患者的临床治疗及细菌耐药性发展的控制提供指导。方法分离自消化内科患者临床标本的鲍曼不动杆菌132株,采用K-B法进行耐药性分析。纯培养后挑取单菌落,加入到含有蛋白酶K溶液的离心管中,经水浴后离心,以设计的引物PCR扩增目的基因片段,观察耐药基因携带情况。结果 132株鲍曼不动杆菌中分离自痰液占71.97%、伤口分泌物占12.88%、脓液占6.82%、尿液占3.03%、其他标本占5.30%。K-B法测定132株鲍曼不动杆菌对阿米卡星、链霉素、庆大霉素、米诺环素、头孢吡肟、头孢噻肟、亚胺培南、美罗培南的耐药率分别为11.36%、55.30%、42.42%、34.85%、53.79%、61.36%、5.30%和10.61%。PCR检测鲍曼不动杆菌分离株的adeB基因大小为541bp,adeJ基因为453bp,abeM基因为781bp,adeR基因为447bp,adeS基因为544bp,检出率分别为38.64%、79.55%、40.91%、32.58%和51.52%;PCR检测鲍曼不动杆菌的耐消毒剂基因qacE△1基因大小为300bp,检出率为53.03%。结论消化内科患者感染的鲍曼不动杆菌对常用治疗药物均产生了一定程度的耐药性,这可能与菌株的外排泵系统基因及耐消毒剂基因携带率较高有一定关系。因此,及时进行细菌病原学及耐药性监测对于患者疾病治疗及控制细菌耐药性发展具有重要意义。 Objective To analyze the systemic mechanism of efflux pumps and the distribution of disinfectant-resistant genes in Acinetobacter baumannii infection in patients with gastrointestinal diseases and provide guidance for the clinical treatment and the development of bacterial resistance in patients. Methods 132 strains of Acinetobacter baumannii isolated from the clinical samples of patients with gastrointestinal diseases were analyzed by K-B method. Single culture after picking a single colony added to the centrifuge tube containing proteinase K solution centrifuged after the water bath to PCR primers designed to amplify the target gene fragment observed resistance gene carrier. Results 132 strains of Acinetobacter baumannii isolated from sputum accounted for 71.97%, wound secretions accounted for 12.88%, pus accounted for 6.82%, urine accounted for 3.03%, other specimens accounted for 5.30%. KB method was used to determine the resistance rates of 132 Acinetobacter baumannii to amikacin, streptomycin, gentamicin, minocycline, cefepime, cefotaxime, imipenem and meropenem 11.36%, 55.30%, 42.42%, 34.85%, 53.79%, 61.36%, 5.30% and 10.61% respectively. The size of adeB gene of Acinetobacter baumannii isolates was 541 bp, the number of adeJ gene was 453 bp, the number of abeM gene was 781 bp, the number of adeR gene was 447 bp and the number of adeS gene was 544 bp. The detection rates were 38.64%, 79.55%, 40.91% 32.58% and 51.52%, respectively. The qacE △ 1 gene of Acinetobacter baumannii resistance agent was 300bp with a detection rate of 53.03%. Conclusion Acinetobacter baumannii infection in patients with digestive diseases have some degree of resistance to commonly used drugs, which may be related to the high rate of gene delivery of the genes and disinfectant genes of the efflux pump strains. Therefore, the timely conduct of bacterial etiology and drug resistance monitoring for the treatment of patients with disease and control the development of bacterial resistance is of great significance.