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目的分析某医院脑膜瘤术后颅内感染的患者中鲍曼不动杆菌(AB)的耐药性与生物膜的相关性。方法选取2016年1-3月脑膜瘤切除术后颅内感染患者脑脊液中分离出的162株AB,采用梅里埃公司全自动微生物VITEK-2分析仪分离鉴定;体外药敏试验采用K-B纸片cc法;以96孔微孔板半定量法测定其生物膜形成能力,对比各类菌株的生物膜阳性率及生物表型分布情况;运用多重PCR技术对亚胺培南敏感和耐药的AB的相关特异基因进行分析。结果162株AB中XDR、MDR的耐药率高达75.31%(122/162);敏感组、MDR组、XDR组的AB中产生物膜率依次为24.70%、35.19%、40.12%。具有产生物膜能力且对亚胺培南敏感和耐药的AB的OXA-23、OXA-51、Car O、及Ade ABC外排泵相关基因中,OXA-51、Car O均被检出,其表达无明显差异,其他基因的表达量差异有统计学意义(P<0.05)。结论OXA-23型AB是该院神经外科行脑膜瘤切除术后院内感染的重要病原菌之一,其生物膜的形成也影响着颅内感染AB的耐药性,临床应提高重视,合理使用抗菌药物。
Objective To analyze the relationship between drug resistance and biofilms in Acinetobacter baumannii (AB) in patients with intracranial infection of meningioma after operation in a hospital. Methods 162 strains of AB isolated from cerebrospinal fluid of patients with intracranial infection after excision of meningiomas from January to March, 2016 were selected and identified by using the automatic microorganism VITEK-2 analyzer of Merial Company. The in vitro susceptibility test was performed using KB paper cc Method; the biofilm formation ability was measured by semi-quantitative method of 96-well microplates, the positive rate of biofilm and the distribution of biological phenotypes were compared among various strains; the multiplex PCR was sensitive and resistant to imipenem Related genes specific analysis. Results The resistance rates of XDR and MDR in 162 strains of AB were as high as 75.31% (122/162). The biofilm rates of AB in sensitive group, MDR group and XDR group were 24.70%, 35.19% and 40.12%, respectively. Among OXA-23, OXA-51, CarO, and Ade ABC efflux pump-related genes that have membrane-forming ability and are sensitive and resistant to imipenem, OXA-51 and CarO are both detected, The expression of other genes had no significant difference (P <0.05). Conclusion OXA-23 type AB is one of the important pathogens of nosocomial infection after neurosurgery in our hospital. The formation of biofilm also affects the drug resistance of intracranial infection of AB. Therefore, we should pay more attention to the rational use of antibacterial drug.