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目的了解本地区耐亚胺培南鲍曼不动杆菌(IRAB)的耐药特征以及D类和B类碳青霉烯酶基因的流行状况。方法收集广东省2家三甲医院临床分离的耐亚胺培南鲍曼不动杆菌70株,采用K-B纸片法进行药敏试验;设计合成D类和B类碳青霉烯酶的引物序列进行PCR扩增和测序分析;热不对称PCR法检测侧翼序列。结果 70株耐亚胺培南鲍曼不动杆菌对13种抗生素的耐药率都在84.29%以上,共有3株鲍曼不动杆菌检出OXA-58-like,60株检出OXA-51-like,23株检出OXA-23-like,4株检出OXA-24-like,另有1株检出了NDM-1基因;NDM-1上游存在ISAba125插入序列。结论鲍曼不动杆菌耐药情况严重,本地区鲍曼不动杆菌D类碳青霉烯酶基因的分布以OXA-23-like为主,同时检测出B类碳青霉烯酶NDM-1,需密切监测。
Objective To investigate the resistance characteristics of Acinetobacter baumannii (IRAB) and the prevalence of class D and B carbapenemase genes in this region. Methods 70 strains of Acinetobacter baumannii isolated from two top-three hospitals in Guangdong Province were collected and susceptible to antibiotics were tested by KB paper method. Primer sequences of class D and class B carbapenems were designed and synthesized PCR amplification and sequencing analysis; thermal asymmetric PCR method to detect flanking sequences. Results The resistance rate of 70 strains of imipenem-resistant Acinetobacter baumannii to 13 kinds of antibiotics was over 84.29%. A total of 3 Acinetobacter baumannii isolates were identified as OXA-58-like and 60 isolates were detected as OXA-51 -like, OXA-23-like was detected in 23 strains, OXA-24-like was detected in 4 strains and NDM-1 gene was detected in 1 strain. ISAba125 was inserted upstream of NDM-1. Conclusion The Acinetobacter baumannii is highly resistant. The distribution of Class D carbapenemycin in Acinetobacter baumannii is mainly OXA-23-like, and the carbapenemase NDM-1 , Need to be closely monitored.