耐碳青霉烯鲍曼不动杆菌基因型检测及其耐药性

Study on genotyping and drug-resistance of carbapenemase-producing Acinetobacter baumannii

目的了解我院鲍曼不动杆菌产碳青霉烯酶基因型分布及其对碳青霉烯类等临床常用抗菌药物耐药的相关性。方法 PCR检测所有菌株IMP、VIM-1、VIM-2、SIM-1、OXA-23、OXA-24、OXA-51(66)、OXA-58等碳青霉烯酶基因型;用纸片扩散(K-B)法检测其对16种常用抗生素的耐药性。结果单产OXA-66型碳青霉烯酶菌株除对亚胺培南、头孢哌酮/舒巴坦、氨苄西林/舒巴坦、哌拉西林/三唑巴坦的耐药率在50%以下外,对其它抗生素耐药率均在50%以上;而同时产OXA-23、OXA-66型碳青霉烯酶菌株除对头孢哌酮/舒巴坦耐药率为53.3%外,对其余抗生素耐药率均超过95%。结论同时产OXA-23型和OXA-66型碳青霉烯酶可能是导致鲍曼不动杆菌对碳青霉烯类药物高度耐药的主要原因之一。

Objective To investigate the genotypes of carbapenemase-producing A.baumannii and its relationship of drug resistance to carbapenem antibiotics commonly used in clinic. Methods The genotypes of carbapenemase-producing A.baumannii including IMP, VIM-2, SIM- 1, OXA-23, OXA24, OXA-51 （66）, OXA- 58 were detected by PCR and the drug resistance of 16 kinds to commonly used antibiotics were detected by disk diffusion. Results The resistance rates to antibiotics of OXA-66 type carbapenemase-producing strains were more than 50% while the resistance rates to antibiotics of both OXA-23 and OXA-66 carbapenemase strains were more than 95%, showing more resistance to antibiotics than that of non-carbapenemase-producing strain. Conclusion The resistance rate of the carbapenemases-producing strains, among which the both OXA- 23 and OXA-66 carbapenemase-producing strains were the best, were significantly higher than that of non- carbapenemase-producing strains.