多重耐药鲍曼不动杆菌氨基糖苷类耐药基因的研究

Study on the aminoglycoside resistance gene of nosocomial multidrug-resistant Acinetobacter baumannii

目的调查山东省潍坊市人民医院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,为院内感染控制提供依据。方法采用VITEK2全自动微生物仪对2013年11月26日至12月12日山东省潍坊市人民医院临床分离的9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度检测采用纸片扩散法。聚合酶链反应检测氨基糖苷类耐药基因,对部分阳性基因进行测序。结果 9株多重耐药鲍曼不动杆菌中,2株aac(3)-Ⅰ基因阳性,3株ant(3″)-Ⅰ基因阳性,3株aac(6′)-Ⅰ基因阳性,9株armA基因阳性。所有菌株对氨基糖苷类抗菌药物阿米卡星、庆大霉素和妥布霉素耐药。5株标本来源于重症监护病房,3株标本来源于神经外科病房。所有标本来源于痰液。结论该院这段时间分离的多重耐药鲍曼不动杆菌对阿米卡星、庆大霉素和妥布霉素同时耐药与携带armA氨基糖苷类耐药基因有关。院感部门应重点监测重症监护病房和神经外科病房多重耐药鲍曼不动杆菌引起的院内感染。

Objective To investigate the prevalence of aminoglycoside resistance gene in multidrug-resistant Acinetobacter baumannii isolated in clinical at a certain time,and to provide the basis for the control of nosocomial infection.Methods 9strains of multidrug-resistant Acinetobacter baumannii were isolated in First People′Hospital of Weifang from November 26,2013 to December 12,2013.Identification of bacteria and susceptibility testing were conducted by VITEK2,and partial antimicrobial drug susceptibility tests were performed by the disk diffusion method.Aminoglycoside resistance genes were detected by PCR and the positive genes were partly sequenced.Results Among the 9stains of multidrug-resistant Acinetobacter baumannii,2strains carried aac（3）-Ⅰ gene,3carried ant（3″）-Ⅰ gene,3carried aac（6′）-Ⅰ gene.AndarmA gene was positive in 9strains.All strains were resistant to aminoglycosides,such as amikacin,gentamicin and tobramycin.There were 5specien issolated in ICU,while 3specimens were isolated in neurosurgery ward.All specimens were separated from sputum.Conclusion Antimicrobial resistance to aminoglycosides of Acinetobacter baumannii isolated in the hospital during this time was related to aminoglycoside resistance gene.Nosocomial infection caused by multidrug-resistant Acinetobacter baumanniiin,ICU and neurosurgery ward should be vigorously monitored.