鲍曼不动杆菌耐药性监测与外排泵adeB基因存在状况分析

Investigation of Acinetobacter Baumannii Drug Resistance and Analysis of Existence of Efflux Pump AdeB Gene

目的探讨我院临床分离鲍曼不动杆菌的耐药性及外排泵adeB基因存在状况。方法WHONET5.6回顾性分析鲍曼不动杆菌耐药性,聚合酶链反应(PCR)扩增检测adeB基因。结果2011年,鲍曼不动杆菌对头孢菌素类、碳青霉烯类、β-内酰胺酶抑制剂、氟喹诺酮类和氨基糖苷类抗菌药物均较敏感,耐药率几乎均在40%以下,2012年出现较大幅度上升,对5大类抗菌药物的耐药率几乎均在50%以上,2013年变化不明显;鲍曼不动杆菌外排泵adeB基因阳性率高(80.9%),多重耐药菌adeB基因阳性率(89.7%)明显高于相对敏感菌adeB基因阳性率(37.5%)(<0.05)。结论鲍曼不动杆菌耐药情况严重,adeB基因阳性率高;主动外排在鲍曼不动杆菌多重耐药中可能发挥重要作用。

Objective To investigate the drug resistance of Acinetobacter baumanni clinical isolates in our hospital and the existence of efflux pump adeB gene.Methods Analysis retrospectively of drug resistance of Acinetobacter baumannii based on WHONET5.6.And the polymerase chain reaction(PCR)was used to amplify the adeB gene.Results In 2011,acinetobacter baumannii were sensitive to the cephalosporin class,carbon penicil ium alkene,β-lactamase inhibitor,fluoroquinolone and aminoglycoside antibiotic drugs,The resistant rates to almost were al below 40%.But it appeared a relatively substantial y rise in 2012,the resistance rates to five categories of antibacterial drug were al above 80%.there were no change obviously in 2013.The rate of efflux pump adeB gene in acinetobacter baumanni is high(80.9%).The positive rate of adeB gene in multi-resistant bacteria(89.7%)was significantly higher than sensitive bacteria(37.5%)(<0.05).Conclusion The drug resistance of Acinetobacter baumanni is in severe cases,and the detection rate of adeB gene is high.The active ef lux pump might play an important role in the formation of multi-drug resistance of Acinetobacter baumanni.