黑龙江东部地区流行鲍曼不动杆菌OXA及AmpC酶基因型分析

Analysis of Acinetobacter baumannii OXA and AmpC gene in eastern Heilongjiang province

目的了解本院鲍曼不动杆菌苯唑西林酶(OXA)和头孢菌素酶(Amp C)相关耐药基因的情况,为临床抗菌药物的合理选择提供依据。方法收集2013年9月-2014年9月本院临床分离鲍曼不动杆菌(AB)标本,VITEK-Ⅱ全自动微生物鉴定/药敏测试系统筛选并进行16S rRNA鉴定;多重PCR检测鲍曼不动杆菌携带的碳青霉烯酶相关耐药基因blaOXA-23、blaOXA-24、blaOXA-51、blaOXA-58、blaADC、blaDHA,对阳性产物DNA序列进行同源性分析。结果 66株(95.7%)携带blaOXA-51基因,32株(46.4%)携带blaOXA-23基因,18株(26.1%)携带blaOXA-24基因,6株(8.7%)携带blaOXA-58基因,53株(76.8%)携带blaADC基因。26株碳青霉烯类抗生素耐药鲍曼不动杆菌中,25株(96.2%)携带balOXA-51基因,24株(92.3%)携带blaADC基因,22株(84.6%)携带blaOXA-23基因,6株(23.1%)携带blaOXA-24基因,3株(11.5%)同时携带blaOXA-23、blaOXA-24、blaOXA-51及blaADC基因。结论产blaOXA-51、blaOXA-23、blaADC型β-内酰胺酶可能是本院鲍曼不动杆菌对碳青霉烯酶类抗菌药物耐药的主要原因,另外本院存在blaOXA-24型耐药基因鲍曼不动杆菌的区域性流行。

Objective To investigate the resistance genes of Acinetobacter baumannii（AB） OXA and AmpC, so as to provide a reasonable basis for the selection of antimicrobial drugs. Methods Clinical specimens were collected at the First Affiliated Hospital of Jiamusi University from September 2013 to September 2014. The VITEK - Ⅱ automated microbial identification/ susceptibility testing system was used to screen and identify 16S rRNA. Multiplex PCR detection method was used to identify Acinetobacter baumannii carrying carbapenem related resistant genes blaOXA-23, blaOXA-24, blaOXA-51, blaOXA-58, blaADc and blabsA. And the homology analysis was conducted on the DNA sequence of positive products. Results The resistant gene test results were obtained as the following, 66 （95.7%） carrying blaOXA-51 gene, 32 （46. 4% ） carrying blaOXA-23 gene, 18 （26.1% ） carrying blaOXA-24 gene, 6 （8.7%） carrying blaOXA -58 gene, 53 （76.8%） carting blaaDc gene. Out of 26 carbapen- em resistant strains of Acinetobacter baumannii, 25 （ 96.2% ） carried blaOXA-51 gene, 24 （ 92.3% ） blaADc gene, 22 （ 84.6% ） carried blaOXA-23 gene, 6 （23.1% ） carried blaOXA-24 gene, 3 （ 11.5% ） carried blaOXA -23 gene, blaOXA-24 gene, blaOXA-51 gene and blaAoc gene. Conclusion β- lactamase producing blaOXA -51, blaOXA-23 and blaADc may be responsible for the main reason of Acinetobacter baumannii carbapenem antimicrobial enzyme resistance. The area prevalence of drug - resistant blaOXA-24 gene of A. baumannii was found in our hospital.