多重耐药鲍曼不动杆菌主动外排泵基因abeM的测定及耐药性分析

Determination of the active efflux pump gene abeM in multi-drug-resistant Acinetobacter baumannii and its drug resistance

目的了解临床分离株鲍曼不动杆菌对16种抗菌药物的耐药性,为抗耐药菌药物选择提供依据,并扩增外排泵蛋白编码基因abeM,以探讨鲍曼不动杆菌多重耐药与主动外排作用的关系。方法采用纸片扩散法（Kirby-Bauer）对收集的65株不重复鲍曼不动杆菌进行药物敏感性试验。应用聚合酶链反应测定多重耐药鲍曼不动杆菌主动外排系统abeM基因,并进行序列分析。结果收集的鲍曼不动杆菌对头孢哌酮/舒巴坦敏感,耐药率15.38%,对亚胺培南耐药率为52.31%,对其余抗菌药物的耐药率在60.00%-73.85%之间;经PCR扩增,65株鲍曼不动杆菌中adeB基因阳性60株（92.31%）,序列分析显示与Genbank登录的鲍曼不动杆菌ATCC 19606药物外排蛋白编码基因abeM（AB204810）的同源性为98.00%。结论 abeM主动外排作用可能是多重耐药鲍曼不动杆菌多重耐药的重要机制之一。

Objective To ascertain the drug resistance of Acinetobacter baumannii isolated from a clinic to provide a basis for antibiotic selection and to investigate the effect of efflux inhibition of the active efflux pump gene abeM on the multi-resistance of A.baumannii.Methods Sixty-five non-repetitive A.baumannii strains were collected and drug sensitivity to 16 antibacterial drugs was determined by the disk diffusion method（Kirby-Bauer）.Then,the active efflux pump abeM gene was identified by polymerase chain reaction（PCR）.Furthermore,PCR products were purified,sequenced,and analyzed.Results The antimicrobial susceptibility test showed that A.baumannii was resistant to cefoperazone/sulbactam at a rate of 15.38%,to imipenem at a rate of 52.31%,and to other antibacterial drugs at rates from 60.00% to 73.92%.Sixty strains of multi-resistant A.baumannii had the abeM gene,which was detected at a rate of 92.31%.Strains had 98.00% homology with sequences of the active efflux pump gene abeM of A.baumannii ATCC 19606（NO AB204810） in GenBank.Conclusion The effect of active efflux pump abeM may be an important mechanism for the multi-drug resistance of multi-drug resistant A.baumannii.