亚胺培南耐药鲍曼不动杆菌耐药基因分析

Drug resistance gene analysis on imipenem-resistant Acinetobacter baumannii

目的了解淮南朝阳医院亚胺培南耐药鲍曼不动杆菌(Acinetobacter baumannii,Ab)耐药基因表型,为指导临床合理用药和院内感染的防控提供依据。方法收集2020年1—12月淮南朝阳医院分离的20株亚胺培南耐药鲍曼不动杆菌,对菌株药敏试验结果进行分析,采用聚合酶链式反应(polymerase chain reaction,PCR)检测各株细菌耐碳青霉烯类基因携带情况。结果20株鲍曼不动杆菌均为呼吸道标本;神经外科11株(55%),重症监护病房(ICU)6株(30%),呼吸科2株(10%),肝胆外科1株(5%)。20株亚胺培南耐药鲍曼不动杆菌除对复方新诺明耐药率较低外,对其它抗生素耐药率均较高。PCR检测20株鲍曼不动杆菌OXA-51和OXA-23均为阳性,OXA-24、VIM-1、VIM-2、IPM-1、NDM-1均未检出。结论淮南朝阳医院亚胺培南耐药鲍曼不动杆菌耐药形势比较严峻,耐药机制可能与OXA-51和OXA-23耐药基因有关。医护人员应当引起重视,医院感染管理科应采取相应措施,避免耐药菌株扩散。

Objective To provide the basis for rational clinical medication and prevention and control of nosocomial infection by understanding the drug resistance gene phenotype of imipenem-resistant Acinetobacter baumannii(Ab)in Huainan Chaoyang Hospital.Methods Twenty strains of imipenem-resistant Acinetobacter baumannii isolated in Huainan Chaoyang Hospital from January to December 2020 were collected,the results of the bacterial susceptibility test was analyze,and polymerase chain reaction(PCR)was used to detect the carrying status of bacterial resistance of carbapenem genes of strains.Results All the 20 strains of Acinetobacter baumannii were respiratory specimens;there were 11 strains for the neurosurgery department(55%),6 strains for intensive care unit(ICU)(30%),2 strains for the respiratory department(10%),and 1 strain in hepatobiliary surgery(5%).The low resistance rate of 20 strains of Acinetobacter baumannii resistant to imipenem against other antibiotics was higher except that against compound trimethoprim.All 20 strains of Acinetobacter baumannii OXA-51 and OXA-23 tested to be positive under the PCR,and neither OXA-24 nor VIM-1 or VIM-2 or IPM-1 or NDM-1 was detected.Conclusion The drug resistance of imipenem-resistant Acinetobacter baumannii in Huainan Chaoyang Hospital is relatively severe,and the resistance mechanism may be related to the resistance genes of OXA-51 and OXA-23.Medical workers should pay close attentions to the problems,and the nosocomial infection control department should take appropriate measures to avoid the spread of drug-resistant strains.