多重耐药鲍曼不动杆菌耐药性及β-内酰胺酶耐药基因的研究

Resistance and Resistant Genes of β-Lactamase in Multiple Drug Resistant Acinetobacter baumannii

研究多重耐药鲍曼不动杆菌的耐药性及β-内酰胺酶耐药基因的携带情况。采用VIKET Compact 2全自动细菌鉴定系统进行细菌鉴定,采用纸片扩散法(K-B法)测定鲍曼不动杆菌对抗菌药物的耐药性,应用聚合酶链反应(PCR)法检测β-内酰胺酶耐药基因。32株多重耐药鲍曼不动杆菌对13种常用抗菌药物的耐药率均>80%,对亚胺培南和美罗培南耐药率分别高达78.1%和71.9%,头孢哌酮/舒巴坦耐药率31.3%,多粘菌素B抗菌活性最好,耐药率0%。检出超广谱β-内酰胺酶(ESBLs)和头孢菌素酶(Amp C)耐药基因,未检出金属β-内酰胺酶(MBLs)耐药基因。32株多重耐药鲍曼不动杆菌TEM基因均阳性,17株检出PER基因,29株检出ADC基因。有16株菌同时携带TEM、PER、ADC基因。结果表明,同时携带TEM、PER、ADC基因是安徽医科大学解放军174临床学院鲍曼不动杆菌产生多重耐药性的原因之一。

The carrying situation of the resistance and the resistant genes of β-1actamases in multiple drug resistant Acinetobacter baumannii （MDR-AB） was studied. The bacterial identification were performed by VITEK 2 compact full-automatic bacterial identification system. Paper diskette diffusion method （ K-B method） was used to detect the drug resistance of A. baumannii to antibiotic drugs. The β-1actamase resistance genes were amplified by PCR. The resuits showed that drug resistance rates of 32 stains of MDR-AB to 13 kinds of commonly used antibiotic drugs were all over 80%. The resistance rates of MDR-AB to imipenem and meropenem were as high as 78.1% and 71.9% , respectively, to cefoperazone/sulbactam was 31.3%. Polymyxin B performed the best antibiotic activity, resistance rates was 0%. The resistance genes of extrabroad-spectrum β-1actamases （ESBLs） and cephalosporinase （AmpC） were detected, but non metal β-1actamase （MBLs） resistance genes was detected. Of 32 strains of MDR-AB, TEM genes were positive in all strains, 17 strains detected PER gene, 29 strains detected ADC genes. 16 strains simultaneously carry TEM, PER, ADC genes. In conclusion, simuhaneously carrying TEM, PER, ADC genes may have been one reason that caused A. baumannii multi-drug resistance.