多重耐药鲍曼不动杆菌RND外排泵基因检测及流行病学分析

The RND efflux pump gene detection of multidrug resistant Acinetobacter baumannii and molecular epidemiology analysis

目的了解宁波地区鲍曼不动杆菌的耐药率及RND外排泵基因的携带情况,研究该菌的流行型别,为临床合理用药及控制医院感染提供依据。方法采用琼脂稀释法检测临床分离的鲍曼不动杆菌对15种抗菌药物的最低抑菌浓度(MIC),PCR检测9种RND外排泵基因的携带情况,脉冲场凝胶电泳(PFGE)技术分析多重耐药鲍曼不动杆菌的同源性。结果 30株鲍曼不动杆菌对临床常用抗生素普遍耐药,对美罗培南和头孢哌酮/舒巴坦的耐药率相对较低;adeABC、ade IJK、ade FGH外排泵基因分布广泛,在敏感菌株中的存在率也很高;PFGE分型结果显示,14株多重耐药鲍曼不动杆菌(MDRAB)主要以流行克隆A为主。结论临床分离鲍曼不动杆菌耐药情况严峻,克隆播散是MDRAB的主要传播方式,携带ade B、ade J等多种外排泵基因是鲍曼不动杆菌多重耐药的重要原因。

Objective To investigate the drug resistance rate of Acinetobacter baumannii and the carrying status of efflux pump gene RND in Ningbo region, and study the epidemic types of this strain, so as to provide evidence for the clinical medicine and the control of hospital infection. Methods Agar dilution test was used to explore the minimum inhibition concentration （MIC） of Acinetobacter baumannii to 15 kinds of antibiotics. Polymerase chain reaction（PCR） was used to detect the carrying status of 9 RND efflux pump genes. Pulsed- field gel electrophoresis （PFGE） was applied to find out the major popular cloning strains for all MDRAB. Results The 30 clinical separated Acinetobacter baumannii strains were resist to most drugs, while, the its drug resistance rates to meropenem and cefoperazone/sulbactam were relatively lower. RND efflux pump gene, adeABC, adelJK and adeFGtt, were widespread. In susceptible strains, it existed widely. Molecular typing results showed that group A was the largest group in muhidrug resistant Acinetobacter baumannii. Conclusion The drug resistance of clinical isotated Acinetobacter baumannii is severe. Cloning spread is the main reason, while the carrying of efflux pump genes, such as adeB, adeJ is also the main reason for the multidrug resistence of Acinetobacter baumannii.