泛耐药鲍曼不动杆菌相关耐药基因检测及亲缘性分析

Detection and consanguinity analysis of drug-resistance genes in pan-drug resistant Acinetobacter baumannii

目的了解临床分离的泛耐药鲍曼不动杆菌（PDR-AB）携带p内酰胺酶（bla）基因、整合酶基因、氨基糖苷类修饰酶（AMEs）基因及喹诺酮类耐药基因情况以及它们的亲缘性关系。方法用PCR及序列分析方法对50株PDR-AB进行各种耐药基因的检测，采用DNAMAN软件进行基因的树状结构的构建和亲缘性分析。结果50株PDR-AB共检测耐药基因21种，TEM、Slaw、PER、VEB-1、CTX-M-1、ADC、IMP-1、IMP-2、VIM-2、OXA．23、OXA-24、IntIl、Int12、胁盱、qnrAm、qnrBm、qnrS、qepA、gyrA突变基因、parC突变基因、Aac（6’）-Ib阳性检出率分别为100％、100％、86％、0、38％、100％、100％、76％、88％、86％、0、98％、22％、2％、6％、60％、6％、0、100％、100％、76％。50株PDR-AB间具有一定的亲缘性。结论PDR-AB同时携带多种耐药基因是导致其对常用药物均耐药的重要原因，临床应加强有效的监测工作来控制PDR-AB传播并选择有效的抗生素进行治疗。

Objective To investigate the existence of the beta-lactamases（bla） genes, aminoglycosides-modifying enzymes（AMEs） genes, integrase genes and quinolone-resistance genes in pan-drug resistant Acinetobacter bawnarmii （PDR-AB） and study the consanguinity among strains isolated from clinical samples in the region. Methods Drug-resis- tance genes in 50 strains of PDR-AB were analyzed by PCR and verified by DNA sequencing. The construction of tree structured consanguinty of detected genes were analyzed by DNAMAN software. Results The positive rates of TEM, SHV, PER, VEB-1, CTX-M-1, ADC, IMP-l, IMP-2, VIM-2, OXA-23, OXA-24, IntlI, Intl2, lntl3, qnrAm, qnrBm, qnrS, qepA , gyrA mutation gene, parC mutation gene, Aac （ 6＇ ） -lb were 100%, 100%, 86%, 0, 38%, 100%, 100% ,76% ,88% ,86% ,0,98% ,22% ,2% ,6% ,60% ,6% ,0,100%, 100% ,76% in the 50 strains of PDR- AB respectively. There were certain phylogenetic relationships among 50 strains of PDR-AB. Conclusions PDR-AB car- rying a variety of resistance genes is the most important reason for the commonly used drugs resistance. It is important to strengthen clinical surveillance to control the spread of the PDR-AB, and choose effective antib^0tics for treatment.