某院住院患者多重耐药鲍曼不动杆菌耐药性及耐药基因检测分析

Analysis of drug resistance and resistance gene detection of multidrug-resistant Acinetobacter baumannii in hospitalized patients of a hospital

目的:分析许昌市中心医院住院患者多重耐药鲍曼不动杆菌(MDR-Ab)耐药性及耐药基因检测结果。方法:选取2021年2月—2024年2月许昌市中心医院住院患者标本中分离出的112株MDR-Ab,分析MDR-Ab对常见抗菌药物的耐药性及耐药基因检测结果。结果:MDR-Ab对头孢吡肟、头孢他啶、头孢噻肟、环丙沙星的耐药率为100%;对氨苄青霉素舒巴坦、阿米卡星、庆大霉素、左氧氟沙星、四环素、头孢哌酮舒巴坦的耐药率高于80%;对亚胺培南、美罗培南的耐药率高于50%;对米诺环素、替加环素、多粘菌素B1的耐药率较低,均低于20%。112株MDR-Ab内检出D类酶耐药基因car O、ade B、OXA-51基因均为112株,OXA-23基因106株;β-内酰胺酶(A类)耐药基因中TEM 112株,PER基因29株;消毒剂耐药基因qac E 60株;氨基糖苷类耐药基因Arm A 88株。112株MDR-Ab均携带多种耐药相关基因,car O、TEM、OXA-51、ade B为100%携带基因;另携带Arm A+OXA-23+qac E基因占比最高(40.07%),其次为携带PER+Arm A+OXA-23+qac E基因(20.54%)。结论:MDR-Ab携带多种耐药基因,主要为car O、ade B、OXA-51、TEM基因,对各类抗菌药物的耐药率有差异,临床用药前需加强药敏试验并检测耐药基因。

Objective:To investigate multidrug-resistant Acinetobacter baumannii(MDR-Ab)resistance and resistance gene detection in hospitalized patients of Xuchang Central Hospital.Methods:112 strains of MDR-Ab isolated within the specimens of hospitalized patients of Xuchang Central Hospital from February 2021 to February 2024 were selected to analyze the resistance of MDR-Ab to common antimicrobial drugs and the results of resistance gene detection.Results:The resistance rate of MDR-Ab to ciprofloxacin and cephalosporin antimicrobial drugs was 100.00%,to amikacin,ampicillin sulbactam,gentamicin,levofloxacin,tetracycline,cefoperazone sulbactam was all higher than 80%,to imipenem and meropenem was over 50%,and to tigecycline,polymyxin B1 and minocycline was all lower than 20%.Within the 112 strains of MDR-Ab,D-class enzyme resistance genes were detected,including car O gene(112 strains),ade B gene(112 strains),and OXA-51 gene(112 strains),OXA-23 gene(106 strains),PER gene(29 strains),TEM gene(112 strains)inβ-lactamase class A enzyme resistance genes,disinfectant resistance gene qac E(60 strains),and aminoglycoside resistance gene Arm A(88 strains).No other genotypes were detected.The 112 strains of MDR-Ab were all carrying multiple drug-resistant genes,in addition to the genotypes of car O,TEM,OXA-51,and ade B genes(100%),the best proportion carried Arm A+OXA-23+qac E genes(40.07%),followed by those carrying PER+Arm A+OXA-23+qac E genes(20.54%).Conclusion:The main resistance genes of MDR-Ab are car O gene,ade B gene,OXA-51 gene,and TEM gene,which are severely resistant to commonly used antimicrobial drugs in the clinic,and the carrying of multiple resistance genes is an important reason for its resistance.It is necessary to strengthen the drug sensitivity test and detect the resistance genes in clinical use of medication so as to guide the rational use of drugs.