ICU耐碳青霉烯类鲍曼不动杆菌bla_(OXA)基因型分析

Analysis of bla_(OXA) genotypes of carbapenem-resistant Acinetobacte baumannii from ICU

目的对2015年1月-4月滨州市人民医院ICU病房检出的耐碳青霉烯类鲍曼不动杆菌基因型进行分析,为本院ICU合理使用抗菌药物和控制感染提供依据。方法采用BD PHOENIX-100全自动微生物分析鉴定系统进行菌株鉴定和药敏试验,结果判定依据NCCLS颁布的标准;聚合酶链反应即PCR法扩增blaOXA-23、blaOXA-24、blaOXA-51、blaOXA-58、blaOXA-60、blaOXA-64、blaIMP-1、blaVIM-2和blaVIM-7基因并对部分阳性菌株进行测序。结果 2015年1月-4月本院ICU共检出14株耐碳氢酶烯类鲍曼不动杆菌,其对米诺环素耐药率<20%;对碳氢酶烯类、氨基糖苷类和氟喹诺酮类药物均耐药,并呈现泛耐药趋势。PCR检测出这14株耐碳氢酶烯类鲍曼不动杆菌blaOXA-23、blaOXA-51、blaOXA-64基因阳性率为100%(14/14),1株携带blaOXA-58基因,未检出blaOXA-24、blaOXA-60、blaIMP-1、blaVIM-2和blaVIM-7基因。结论本院ICU病房检出的14株耐碳氢酶烯类鲍曼不动杆菌均携带blaOXA-23、blaOXA-51和blaOXA-64基因,并且有1株同时携带blaOXA-58基因,与以往研究不同,应引起临床重视。

Objective To analyze the genotypes of carbapenem - resistance Acinetobacter baumannii in ICU during January to April in 2015, so as to provide basis for the rational use of anti - bacterial medicine and the control of infection in ICU. Meth- ods Strain identification and susceptibility testing were performed using BD PHOENIX - 100, and the results were valued ac- cording to the standards of NCCLS. The genotype of 14 strains of A. baaumannii OXA- carbapenemases（ blaOXA-23, blaOXA-24, blaOXA-51 , blaOXA-58 , blaOXA-60 , blaOXA-64 ） , blaIMP-1 and blaVIM-2 ,blaVIM-7 ） were detected by PCR. Results The 14 strains were detected and resistant to A. baumannii to tominocycline during January - April in 2015 with the resistance rate less than 20% to minocycline, which was resistant to carbapenems, aminoglycoside and quinolones, showing a trend of pan resistance. The positive rate of blaOXA-23 , blaOXA -51 and blaOXA-64 of 14 strains of carbapenem - resistant A. baaumannii by PCR was 100% （14/14） , with 1 strain carrying OXA-58 And blaOXA-24, blaOXA-60, blaIMP-1, blaVIM-2 and blaVIM-7 genes were not detected. Conclusion The 14 strains A. baumannii resistant to tominocycline carry blaOXA-23 , blaOXA-51 and blaOXA-64 gene, one of which also produced blaOXA-58 gene. It＇s different from other research before and necessary to be paid attention.