多重耐药鲍曼不动杆菌临床分布及外排泵基因的检测

Clinical Distribution and the Detection of Multiple Drug-Resistant Acinetobacter Baumannii Efflux Pump Genotypes

目的了解多重耐药鲍曼不动杆菌临床分布并检测其外排泵基因型。方法统计96株多重耐药鲍曼不动杆菌临床分布,用Kirby-Bauer法检测96株多重耐药鲍曼不动杆菌对15种抗菌药物的耐药情况,并用PCR扩增进行外排泵基因的检测。结果 96株多重耐药鲍曼不动杆菌主要分布在重症监护病房(54.2%)和呼吸内科(18.8%);对喹诺酮类、头孢菌素类、氨基糖苷类、四环素类抗菌药物的耐药率均在70%以上;分布在重症监护病房的52株多重耐药鲍曼不动杆菌中检测到ade B、ade R、ade S、ade J、ade E、abe M基因分别有18株(34.62%)、16株(30.77%)、18株(34.62%)、18株(34.62%)、0株、18株(34.62%);分布在呼吸内科的18株多重耐药鲍曼不动杆菌中检测到ade B、ade R、ade S、ade J、ade E、abe M基因分别有9株、8株、8株、8株、0株、8株。结论外排泵基因是分布在重症监护病房和呼吸内科的鲍曼不动杆菌发生多重耐药的重要因素。

Objective To study the clinical distribution and detection of the efflux pump gene in multiple drug-resistant acinetobacter baumannii. Methods The clinical distribution of 96 strains of multiple drug-resistant acinetobacter baumannii was analyzed. K-B method was used to detect 96 strains of multi resistant bauman resisted to 15 kinds of antibiotics. PCR amplification was used to detect the efflux pump gene. Results Ninety-six strains of multiple drug-resistant acinetobacter baumannii mainly distributed in intensive care unit （ICU, 54.2%） and respiratory department （18.8%）. The drug resistance rates to quinolone, cephalosporins, amino glucoside, tetracycline were above 70%. The 52 strains of multiple drug-resistant acinetobacter baumannii detected in ICU included 18 strains of adeB （34.62%）, 16 strains of adeR （30.77%）, 18 strains of adeS （34.62%）, 18 strains of adeJ （34.62%）, 0 strain of adeE and18 strains of adeM （34.62%）. The18 strains of multiple drug-resistant acinetobacter baumannii detected in respiratory department included 9 strains of adeB, 8 strains of adeR, 8 strains of adeS, 8 strains of adeJ, 0 strain of adeE and 8 strains of adeM. Conclusion Efflux pump genes are important factors for multiple drug-resistant acinetobacter baumannii distributed in ICU and respiratory department.