广州地区多药耐药鲍氏不动杆菌的同源性分析

Homology of multidrug-resistant Acinetobacter baumanniiin Guangzhou

目的分析广州地区多药耐药鲍氏不动杆菌的同源性,为临床预防治疗和控制医院感染提供依据。方法收集广州地区多所三级甲等医院临床标本分离的非重复多药耐药鲍氏不动杆菌113株,并用纸片扩散法进行药敏试验,使用细菌基因组重复序列PCR(REP-PCR)技术以及DiversiLab细菌同源性分析技术对菌株进行同源性分析。结果 113株多药耐药鲍氏不动杆菌对阿米卡星耐药率为11.5%、亚胺培南75.2%、美罗培南73.5%、头孢哌酮/舒巴坦69.0%,对其他头孢菌素类、氨基糖苷类、氟喹喏酮类等抗菌药物均显示出高水平的耐药,耐药率为80.0%～100.0%;REP-PCR将113株鲍氏不动杆菌分为4组基因型(A～D),其中A型62株,为主要的流行型别,分别为A1型31株、A2型12株、A3型10株、A4型9株;B型29株分别为B1型18株、B2型11株;C型19株分别为C1型11株、C2型8株;D型3株。结论广州地区多药耐鲍氏不动杆菌耐药率较高,且大多数菌株具有高度同源性。

OBJECTIVE To investigate the homology of multidrug-resistant Acinetobacter baumannii （MDRAB） in Guangzhou so as to provide bases for clinical prevention and treatment of nosocomial infections. METHODS A total of 113 MDRAB strains were collected from several hospitals of Guangzhou. The antibiotic susceptibility were tested by disk diffusion method, the genotyping and dendrogram analysis of MDRAB strains were performed using the repetitive sequence-based polymerase chain reaction （REP-PCR） and DiversiLabTM microbial typing system. RESULTS The drug resistance rates of the 113 strains of MDRAB to amikacin, imipenem, meropenem, and cefoperazone/sulbactam were 11.5%, 75.2%, 73.5%, and 69.0%, respectively, the drug resistance rates to cephalosporins, aminoglycosides, and fluoroquinolones ranged from 80.0% to 100.0%; all the 113 isolates were divided into 4 groups of genotypes （A%D） by REP-PCR, there 62 strains of type A which was the most prevalent type, including 31 strains of A1, 12 strains of A2, 10 strains of A3, and 9 strains of A4; there were 29 strains of type B including 18 strains of B1, 11 strains of B2; there were 19 strains of type C, including 11 strains of C1 and 8 strains of C2; there were 2 strains of type D. CONCLUSION Multidrug-resistant Acinetobacter baumannii strains isolated from Guangzhou are highly drug resistant, most of which are highly homologous.