多重耐药鲍曼不动杆菌耐药基因分析与同源性分析

Drug-resistant gene analysis and homology analysis of multidrug-resistant Acinetobacter Baumanii

目的:对本院分离的多重耐药鲍曼不动杆菌(MDRAB)耐药及介导耐药基因进行检测分析,对分离自呼吸重症监护病房(RICU)的菌株基因同源性进行流行病学分析。方法:收集2009年1月至2010年12月期间分离的85株多重耐药鲍曼不动杆菌,用K-B法进行药敏实验,用PCR方法检测OXA-23、OXA-58,qacE△1、IMP,VIM基因,并利用脉冲场凝胶电泳(PFGE)对分离自呼吸监护病区的14株菌株进行基因同源性分析。结果:85株耐药菌中OXA-23、qacE△1基因的阳性率依次为55.3%、81.2%,未检测到OXA-58,VIM和IMP基因。用PFGE技术将分离自呼吸监护病区的14株MDRAB分为5型,以A和B型为主。结论:本院分离的MDRAB对临床常用的抗生素耐药性比较严重,其中耐碳青霉烯类鲍曼不动杆菌(CRAB)情况更甚;14株RICU菌株中有A型6株(均为CRAB),分离于2010年7-9月,提示CRAB在2010年第三季度于RICU有小范围的暴发流行。

Objective To analyze the resistance of multidrug-resistant Acinetobaeter Baumanii （MDRAB） and the drug-resistant gene, and to analyze the homology of Aeinetobacter Baumannii isolated from respiratory intensive care unit （RICU）. Methods The drag sensitivity test was determined in 85 MDRAB isolated from Jan 2009 to Dec 2010 by K-B method; and OXA-23, OXA-58, qacE△1, IMP and VIM genes were determined by PCR. The bomology analysis of the strains from RICU was carried out by pulsed field gel electrophoresis （PFGE）. Results The positive rates of OXA-23 and qacE△1 were 55.3% and 81.2%, respectively; while OXA-58, VIM, and IMP weren＇t detected. 14 MDRAB from RICU were classified into 5 types by PFGE, among which A and B types were the most. Conclusion The MDRAB were resistant to almost all drugs used commonly, and the Carbapenems-Resistant Acinetobacter Baumanii （CRAB） was more serious. 6 of 14 strains from RICL were A type （all were CRAB）, and weir isolated from July to September 2010, indicating that CRAB had small-scale outbreaks in RICU in the third quarter of 2010.