ICU鲍氏不动杆菌分离株耐药性和氨基糖苷修饰酶基因的研究

Drug-resistance and Aminoglycoside Modifying Enzymes Genes in Acinetobacter baumannii Isolated from ICU

目的了解ICU分离的鲍氏不动杆菌(ABA)耐药性及氨基糖苷修饰酶基因存在状况。方法用K-B法检测2005-2007年的291株ABA对14种临床常用抗菌药物的敏感性;用PCR检测2005年部分菌株的氨基糖苷类修饰酶(AME)基因。结果除头孢哌酮/舒巴坦(12.7%)外,其他13种抗菌药物的耐药率达33.0%～91.8%,阿米卡星、庆大霉素和妥布霉素的耐药率为41.2%、61.2%和61.5%;27株ABA中有23株检出AME基因阳性,总阳性率74.4%;阳性包括aac(3)-Ⅰ21株(77.8%),aac(6′)-Ⅰ23株(85.2%)和ant(3″)-Ⅰ23株(85.2%);其中有2株菌同时检出2种基因,21株菌同时检出3种基因,其余基因均为阴性。结论ICU分离的ABA耐药性强,AME基因携带率高,是医院感染预防与控制的重点病区。

OBJECTIVE To investigate the drug-resistance and aminoglycoside modifying enzymes （AME） in Acine- tobacter baumannii （ABA） isolated from ICU. METHODS K-B method was conducted to detect the sensitivity to 14 common antibiotics of 291 strains of ABA isolated from 2005 to 2007; PCR was used to detect AME genes of partial bacteria isolated in 2005. RESULTS The drug-resistance rates of 13 kinds of antibiotics were 33.0-91.8M, but cefoperazone/sulbactam was low （12.7%）. The rate of amikacin, gentamicin and tobramycin was 41. 2%, 61.2% and 61.5%. Twenty-three ABA strains were AME gene positive from total 27 ABA strains and the total positive rate was 74.4%. We found 21 strains with aac（3）-Ⅰ （77.8%）, 23 strains with aac（6′）-Ⅰ （85.2%） and 23 strains with ant（3″）-Ⅰ （85.2%）. Two strains were found to have 2 kinds of AME genes, 21 strains had 3 kinds of AME genes. The rest of ABA strains had not AME genes. CONCLUSIONS ABA isolated from ICU has strong drug-resistance rate and a high carrier rate, it is a critical area of preventing and controlling hospital infection.