泛耐药鲍曼不动杆菌β-内酰胺类抗菌药物耐药机制研究

Study on the Mechanism of Drug Resistance of Pan-drug-resistant Acinetobacter Baumannii β-lactam Antibiotics

目的 探讨一组泛耐药鲍氏不动杆菌β-内酰胺类抗菌药物耐药机制.方法 收集2015年1月~6月湖北省黄石市中心医院(A)住院患者中分离的20株泛耐药鲍氏不动杆菌,用mdfA测序确认菌种,再采用聚合酶链反应(PCR)法分析32种β-内酰胺类药物获得性耐药基因、1种膜孔蛋白carO基因、1种获得性外排泵adeB泵蛋白基因.结果 20株泛耐药鲍氏不动杆菌共检出4种β-内酰胺类获得性耐药基因,A类β-内酰胺酶基因TEM、C类β-内酰胺酶基因ADC、D类β-内酰胺酶基因OXA-23、OXA-51,四者阳性率均为100.00%;B类β-内酰胺酶基因未检出;膜孔蛋白carO基因缺失率为100.00%,外排泵adeB基因阳性率为95.00%.结论 泛耐药鲍氏不动杆菌中携带的耐药基因和耐药表型相对应,对β-内酰胺类药物耐药与产TEM、ADC、OXA-23、OXA-51β-内酰胺酶基因,膜孔蛋白carO基因缺失和获得外排泵adeB3种耐药机制有关.

Objective To investigate the drug resistance mechanism of a group of Pan-drug-resistant Acinetobacter baumanniiβ-lactam antibiotics.Methods 20 strains of Pan-drug-resistant Acinetobacter baumannii isolated from hospitalized patients in central hospital of Huangshi(A)in Hubei province from January to June 2015 were collected.The strains were confirmed by mdfA sequencing,and then polymerase chain reaction(PCR)The results showed that there were 32β-lactam drug resistance genes,1 membrane pore protein carO gene and 1 adaptive efflux pump adeB pump gene.Results 20 strains of pan-resistant acinetobacter baumannii were detected four kinds ofβ-lactam acquired resistance genes,class Aβ-lactamase gene TEM,C-typeβ-lactamase gene ADC,D-typeβ-lactamase gene OXA-23,OXA-51,the four were 100.00%positive rate;The amidase gene was not detected;membrane hole protein carO gene deletion rate was 100.00%,efflux pump adeB gene positive rate was 95.00%.Conclusion The resistance genes and drug resistance phenotypes carried by the drug-resistant acinetobacter baumannii strains correspond toβ-lactam drug resistance and the production of TEM,ADC,OXA-23 and OXA-51β-lactamase genes,deletion of membrane pore protein carO gene and efflux pump adeB3 resistance mechanism.