院内多重耐药鲍曼不动杆菌的分布及氨基糖苷类耐药基因的研究

Analysis on the distribution of nosocomial multidrug-resistant Acinetobacter baumannii and the aminoglycoside resistance gene

目的研究临床分离的多重耐药鲍曼不动杆菌氨基糖苷类耐药基因的流行情况及标本的来源,为临床控制感染提供依据。方法采用VITEK-2全自动微生物仪对2013年10月至2013年12月济宁市第一人民医院临床分离的15株多重耐药鲍曼不动杆菌进行细菌鉴定和药敏试验,部分抗菌药物的敏感性采用纸片扩散法。PCR法检测氨基糖苷类耐药基因,对部分阳性基因进行测序。结果 15株多重耐药鲍曼不动杆菌中,ant(3")-Ⅰ基因73.3%(11/15)阳性,aac(6')-Ⅰ基因66.7%(10/15)阳性,arm A基因93.3%(14/15)阳性。93.3%(14/15)的标本分布在ICU病房,6.7%(1/15)的标本分布在神经外科病房。所有标本来源于痰液。结论该院临床分离的多重耐药鲍曼不动杆菌对氨基糖苷类抗菌药物耐药与同时携带多种氨基糖苷类耐药基因有关。应重点控制和预防ICU重症监护病房多重耐药鲍曼不动杆菌引起的院内感染。

Objective To investigate the prevalence and source of specimen of aminoglycoside resistance gene on clinical isolated multidrug-resistant Acinetobacter baumannii, and to guide the clinical infection control. Methods Identiifcation of bacteria and susceptibility test were conducted on 15 stains of multidrug-resistant Acinetobacter baumannii isolated from October 2013 to December 2013 in First People’ Hospital of Jining, and partial antimicrobial drug susceptibility were detected by the disk diffusion method. Aminoglycoside resistance gene was detected by PCR and the positive gene was partly sequenced. Results Among the 15 stains of multidrug-resistant Acinetobacter baumannii, ant（3＂）-Ⅰgene showed 73.3%（11/15） positive, aac（6＇）-Ⅰgene with 66.7%（10/15） positive and armA gene with 93.3%（14/15） positive. There were 93.3%（14/15） of specimens distributed in ICU, while 6.7%（1/15） in neurosurgery ward. All specimens were from sputum. Conclusions Antimicrobial resistance to aminoglycosides of multidrug-resistant Acinetobacter baumannii isolated in the hospital was related to meanwhile carrying multiple aminoglycoside resistance gene. Nosocomial infection caused by multidrug-resistant Acinetobacter baumannii in ICU should be vigorously controlled and prevented.