多药耐药鲍氏不动杆菌同一病区分离株耐药基因研究

发布时间：2018-01-28 04:30

  本文关键词： 鲍氏不动杆菌 β-内酰胺类 氨基糖苷类 喹诺酮类 可移动遗传元件 多耐药　出处：《中华医院感染学杂志》2016年19期 　论文类型：期刊论文

【摘要】：目的调查同一病区分离的多药耐药鲍氏不动杆菌耐药基因状况及菌株间的亲缘关系。方法收集医院2014年1-12月有呼吸道炎症住院患者痰标本中分离的多药耐药鲍氏不动杆菌25株,先经鲍氏不动杆菌种特异基因PCR检测确认菌种,再用PCR方法分析11种β-内酰胺类耐药基因、3种β-内酰胺类耐药基因与插入序列连锁检测、9种氨基糖苷类耐药基因、1种喹诺酮类耐药基因、2种可移动遗传元件标记,再对检测结果作样本聚类分析。结果 25株多药耐药鲍氏不动杆菌每株均检出β-内酰胺类、氨基糖苷类耐药基因和喹诺酮类药物作用靶位gyrA基因的突变,共检出3种β-内酰胺类耐药基因(blaTEM、blaSHV、blaADC),6种氨基糖苷类耐药基因(armA、aac(3)-Ⅰ、aac(3)-Ⅱ、aac(6′)-Ⅰb、ant(3″)-Ⅰ、ant(2″)-Ⅰ),喹诺酮类药物作用靶位gyrA基因均存在突变,2种可移动遗传元件标记(intⅠ1、ISaba1);blaADC基因与ISaba1连锁,连锁率100.0%;样本聚类分析显示,该组菌存在5个克隆传播,25株可分A与B簇群,A簇群又可分为A-1与A-2亚簇群,A-1亚簇群中1-2-9-10-11号株,A-2亚簇群中3-6-7-14号株与15-17为克隆传播,B簇群又可分为B-1与B-2亚簇群,B-1亚簇群中5-13-16-19-22-23-24号株与20-21为克隆传播。结论多药耐药鲍氏不动杆菌菌株聚集现象明显,5个克隆传播提示有医院感染的存在,将耐药菌检测到的耐药基因阴性与阳性二元结果作样本聚类分析进而解析耐药菌株之间的亲缘关系,对医院感染实时监测和控制医院感染意义重大。
[Abstract]:Objective to investigate the status of multidrug resistance genes of Acinetobacter baumannii isolated from the same area and the relationship between them. Methods the sputum samples of hospitalized patients with respiratory tract inflammation from 2014 to December were collected. Multidrug resistant Acinetobacter baumannii 25 strains. Acinetobacter baumannii species-specific gene PCR was used to identify the strain, and then 11 尾 -lactam resistant genes and three 尾 -lactam resistance genes were detected by PCR method. Nine aminoglycoside resistance genes, one quinolone resistance gene and two transportable genetic element markers. The results were analyzed by cluster analysis. Results 尾-lactams were detected in 25 strains of Acinetobacter baumannii. The mutations of aminoglycoside resistance gene and quinolone target gyrA gene were used to detect three 尾 -lactam resistance genes, namely, blaTEM, blaSHV blaADC. Six aminoglycoside resistant genes, armAcara Aacanus 3HY- 鈪，

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