徐州地区泛耐药鲍曼不动杆菌相关耐药基因及流行病学分析

Related drug resistant genes and epidemiological analysis of extend-drug resistant Acinetobacter baumannii in Xuzhou area

目的调查本地区泛耐药鲍曼不动杆菌(extend-drug resistant Acinetobacter baumannii,XDR-AB)37种耐药基因的携带情况及亲缘性关系,包括2种管家基因以及35种获得性耐药基因。方法基于K-B纸片法检测菌株对16种抗菌药物的敏感性,采用聚合酶链反应检测耐药基因并通过SPSS软件进行样本聚类分析。结果54株XDR-AB菌株共检测到18种阳性基因,包括OXA-23(53株)、strB(52株)、CarO和abeM(51株)、ADCs(49株)、adeB、aacC和OXA-51(各48株)、adeA(45株)、SHV(26株)、adeC(14株)、CTX-M-9(6株)、IMP(5株)、qacE和CTX-M-1(4株)、tetA(3株)、gyrA(2株)、OmpW(1株),同源性菌株分布于临床不同科室。结论本地区XDR-AB耐药基因主要集中在β-内酰胺酶、外排泵、氨基糖苷类耐药基因并存在流行传播趋势,应采取有效控制措施并选择联合药物治疗,防止细菌耐药的进一步增加。

Objective To investigate the presence of 37 drug resistant genes in extend-drug resistant Acinetobacter baumannii(XDR-AB)in this region,including 2 housekeeping genes and 35 acquired drug resistant genes.Methods The sensitivity of XDR-AB strains to 16 types of antimicrobial drugs were detected using the K-B disc method.The resistant genes were detected by polymerase chain reaction,and cluster analysis was conducted by SPSS software.Results A total of 18 positive genes were detected in 54 XDR-AB strains,including OXA-23(53 strains),strB(52 strains),CarO and abeM(51 strains),ADCs(49 strains),adeB,aacC and OXA-51(each with 48 strains),adeA(45 strains),SHV(26 strains),adeC(14 strains),CTX-M-9(6 strains),IMP(5strains),qacE and CTX-M-1(each with 4 strains),tetA(3 strains),gyrA(2 strains),and OmpW(1 strain).Homologous strains were distributed in different clinical departments.Conclusions The drug resistant genes of XDR-AB in this region mainly includeβ-lactamase,efflux pump,and aminoglycosides,with a continuous spread trend.Effective control measures and combined therapeutic regimens should be taken to prevent increased bacterial resistance.