摘要
目的研究多重耐药鲍氏不动杆菌(MDR-AB)流行病学特征、耐药性及部分耐药基因阳性率。方法留取2016年7月-2017年2月于医院住院患者送检标本中分离的64株MDR-AB,统计流行病学特征,检测对15种抗菌药物的敏感性,并采用PCR技术检测TEM、ADC、OXA-23、OXA-51、ISAba1、armA、ant(3″)-Ⅰ、aac(3)-Ⅰ、aac(6′)-Ⅰ、sul1、sul2耐药基因的携带情况。结果 64株MDR-AB中,科室分布以急诊ICU为主,15株占23.44%,其次为ICU、脑中心ICU;标本来源以痰标本为主,48株占75.00%,其次为分泌物;对哌拉西林、头孢吡肟、头孢他啶、头孢曲松、哌拉西林/他唑巴坦、美罗培南、亚胺培南全部耐药,对复方新诺明的耐药性最低;以上耐药基因均有检出,β-内酰胺酶耐药基因阳性率均>80%,其中OXA-51、ISAba1基因的检出率为100.00%,氨基糖苷类修饰酶耐药基因中ant(3″)-Ⅰ的阳性率>70%,aac(3)-Ⅰ、aac(6′)-Ⅰ阳性率则较低。结论医院MDRAB耐药性强,耐药与所检测11种耐药基因有关,应进一步促进抗菌药物的合理应用。
OBJECTIVE To investigate the epidemiological characteristics,drug resistance and positive rate of resistant genes of multidrug-resistant Acinetobacter baumannii(MDR-AB).METHODS The clinical isolates of 64 strains of MDR-AB from hospitalized patients from Jul.2016 to Feb.2017 were collected.Epidemiological characteristics were statistically analyzed,the sensitivities to 15 kinds of antibiotics were detected,and PCR was used to detect the expressions of TEM,ADC,OXA-23,OXA-51,ISAba1,armA,ant(3″)-Ⅰ,aac(3)-Ⅰ,aac(6′)-Ⅰ,sul1 and sul2.RESULTS Among the 64 strains of MDR-AB,the departments were mainly distributed in emergency ICU,which were 15 strains accounting for 23.44%,followed by ICU and brain center ICU.The samples were mainly sputum specimens,which were 48 strains accounting for 75.00%,followed by secretions.They were all resistant to piperacillin,cefepime,ceftazidime,ceftriaxone,piperacillin/tazobactam,meropenem and imipenem,and the drug resistance to compound sulfamethoxazole was the lowest.All the resistant genes were detected.The positive rate ofβ-lactamase resistance gene was80%,and the detection rates of OXA-51 and ISAba1 genes were 100.00%.The positive rate of ant(3″)-Ⅰin the aminoglycoside modifying enzyme resistance gene70%,and the positive rates of aac(3)-Ⅰ and aac(6′)-Ⅰ were lower.CONCLUSION The drug resistance of MDR-AB in our hospital is strong.Drug resistance is related to the detected 11 kinds of resistant genes,and further rational use of antibiotics should be promoted.
作者
柳晓蕾
郭文臣
杨宝宏
王振明
刘婷
孙开宇
LIU Xiao-lei;GUO Wen-chen;Yang Bao-hong;WANG Zhen-ming;LIU Ting;SUN Kai-yu(Institute of Weifang People's Hospital,Weifang,Shandong 261000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第15期2245-2248,2260,共5页
Chinese Journal of Nosocomiology
基金
山东省潍坊市卫生局科研基金资助项目(0000441)
关键词
多重耐药鲍氏不动杆菌
耐药性
耐药基因
抗菌药物
合理应用
Multidrug-resistant Acinetobacter baumannii
Drug resistance
Resistant genes
Antibiotics
Rationaluse