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目的分析我院鲍曼不动杆菌(acinetobacter baumannii,AB)耐药相关基因β-内酰胺酶(OXA、Amp C)及插入序列(ISAba1)的携带情况,为地区流行病学及抗菌药物的合理应用提供依据。方法收集2013年9月—2014年9月佳木斯大学附属第一医院临床分离鲍曼不动杆菌,VITEK-II测试系统菌种鉴定及药敏检测,并进行16SrRNA鉴定;多重PCR检测鲍曼不动杆菌携带的相关耐药基因bla OXA-23、bla OXA-24、bla OXA-51、bla OXA-58、bla ADC、bla DHA及插入序列ISAba1。结果鲍曼不动杆菌对头孢哌酮/舒巴坦、亚胺培南、美洛培南的耐药率分别为12.5%、36.7%、38.5%。66株(95.7%)携带bla OXA-51基因,32株(46.4%)携带bla OXA-23基因,53株(76.8%)携带bla ADC基因,34株(49.3%)携带ISAba1插入序列。碳青霉烯类耐药的鲍曼不动杆菌中,22株(84.6%)携带bla OXA-23,其中19株(73.1%)上游检测到ISAba1,24株(92.3%)携带bla ADC,其中10株上游检测到ISAba1。结论产bla OXA-23、bla ADC型β-内酰胺酶可能是我院鲍曼不动杆菌耐药的主要原因,插入序列(ISAba1)可能增强水解酶表达从而加强耐药。
OBJECTIVE: To analyze the carrying status of drug-resistant gene β-lactamase (OXA, Amp C) and insert (ISAba1) of Acinetobacter baumannii (AB) in our hospital. Application basis. Methods The clinical isolates of Acinetobacter baumannii and VITEK-II from the First Affiliated Hospital of Jiamusi University from September 2013 to September 2014 were collected for drug identification and drug susceptibility testing. 16S rRNA was identified by multiplex PCR. The related drug resistance genes bla OXA-23, bla OXA-24, bla OXA-51, bla OXA-58, bla ADC, bla DHA and the inserted sequence ISAba1 were introduced into the bacilli. Results The rates of resistance to cefoperazone / sulbactam, imipenem and meropenem in Acinetobacter baumannii were 12.5%, 36.7% and 38.5%, respectively. 66 (95.7%) carry bla OXA-51 gene, 32 (46.4%) carry bla OXA-23 gene, 53 (76.8%) carry bla ADC gene and 34 (49.3%) carry ISAba1 insert. Among the 22 strains (84.6%) carrying bla OXA-23, among which carbapenem-resistant Acinetobacter baumannii (22 strains) (84.1%) had ISAba1 upstream and 24 strains (92.3% Upstream of 10 isolates detected ISAba1. Conclusion Production of bla OXA-23, bla ADC type β-lactamase may be the main cause of Acinetobacter baumannii resistance in our hospital. The inserted sequence (ISAba1) may enhance the expression of hydrolase and enhance drug resistance.