鲍氏不动杆菌耐药性及blaOXA基因检测

Drug resistance of Acinetobacter baumannii and detection of blaOX Agene

目的了解鲍氏不动杆菌(ABA)的耐药特点及blaOXA基因类型,为临床合理使用抗菌药物、有效控制医院感染的发生提供科学依据。方法收集医院自2006年1月-2009年12月临床感染标本分离的鲍氏不动杆菌309株采用K-B法进行药敏试验;利用PCR技术检测blaOXA-23、blaOXA-24、blaOXA-51和blaOXA-58基因。结果 309株ABA对亚胺培南、美罗培南的耐药率最低,分别为19.7%、20.4%,其次是米诺环素29.5%,阿米卡星39.9%,对其余17种抗菌药物的耐药率均在>45.0%;blaOXA-23基因阳性46株,占14.9%,OXA-51基因阳性302株,占97.7%,未检测到blaOXA-24、blaOXA-58基因型。结论鲍氏不动杆菌耐药情况严重,blaOXA-23型碳青酶烯酶基因的产生是鲍氏不动杆菌耐药的重要机制之一。

OBJECTIVE To investigate the characteristics of drug resistance of Acinetobacter baumannii and observe the blaOXA genotypes so as to provide scientific bases for reasonable clinical use of antibiotics and effective control of nosocomial infections .METHODS From Jan 2006 to Dec 2009 ,totally 309 strains of A .baumannii isolated from infectious specimens were collected ,then the drug susceptibility testing was performed with the use of K-B meth-od ,and the PCR technique was employed to detect the blaOXA-23 ,blaOXA-24 ,blaOXA-51 ,and blaOXA-58 gene .RESULTS The drug resistance rate of the 309 strains of A .baumannii to imipenem was 19 .7% ,meropenem 20 .4% ,minocycline 29 .5% ,amikacin 39 .9% ;the drug resistance rates to other 17 antibiotics were more than 45 .0% .There were 46 （14 .9% ） strains with blaOXA-23 tested positive and 302 （97 .7% ） strains with blaOXA-51 tested positive ,while the genotypes of blaOXA-24 and blaOXA-58 have not been detected .CONCLUSION The A .baumannii strains are highly drug resistant ,and the production of carbapenemase gene blaOXA-23 is one of the important mechanisms of resistance of the A .baumannii .