赣南地区耐碳青霉烯鲍曼不动杆菌耐药基因及同源性分析

Resistance Gene and Homology Analysis of Carbapenem Resistant Acinetobacter Bauman in South Jiangxi

目的:分析赣南地区耐碳青霉烯鲍曼不动杆菌(CRAB)OXA型、IMP型基因携带情况及其同源性分析,为预防CRAB院内暴发流行提供实验室依据。方法:收集2016年1月至2017年9月赣州市人民医院临床分离290株CRAB,PCR分析其耐药基因,PFGE同源性分析。结果:290株CRAB共获4种(A^D型)PFGE型别,76.6%(222/290)CRAB携带blaOXA-23-like基因,且主要为克隆A(180/290)和C(42/290);20.7%(60/290)CRAB携带blaOXA-24-like基因,为克隆B;2.3%(8/290)携带blaOXA-58-like基因,PFGE型别为D型。5.2%(15/290)CRAB检出B类IMP基因,PFGE分型为克隆B和D型。结论:赣南地区CRAB与国内相关报道相似,以携带OXA-23基因为主;从克隆株的流行情况来分析,医务人员的手卫生及多重耐药菌消毒隔离制度需要加强执行。赣州市人民医院多重耐药菌株预警机制(消毒隔离制度、医务人员手卫生)对预防和控医院内CRAB的播散发挥着重要作用。

Objective:To analyze the status and homology of imp gene of carbapenem-resistant Acinetobacter baumannii(CRAB)in south Jiangxi.Methods:From January 2016 to September 2017,the clinical isolates of 290 strains of CRAB were collected to analyze their drug resistance genes.The homology of PFGE was analyzed.Results:There were 4 PFGE types of Agna D type in 290 strains of CRAB.76.6%222/290 CRAB carries the blaOXA-23-like gene,and it is mainly composed of Cloning of An 180/290)and Con 42/290,20.70%60/290 CRAB carried the blaOXA-24-like gene,which was cloned as B;(2/2/290)the type of blaOXA-58-like gene was D type.5.2and 15/290 IMP gene was detected by CRAB.Conclusion:In south Jiangxi,CRAB is similar to the related domestic reports to carry OXA-23 gene.According to the prevalence of clonal strains,the system of disinfection and isolation of hand hygiene and multidrug-resistant bacteria in medical staff needs to be strengthened.Ganzhou People's Hospital multi-drug resistant strains early warning mechanism(disinfection and isolation system,medical staff hand hygiene)plays an important role in the prevention and control of hospital CRAB.