非多重耐药及多重耐药鲍曼不动杆菌外排泵及其表达

发布时间：2018-03-05 21:00

本文选题：鲍曼不动杆菌　切入点：多重耐药　出处：《西安交通大学学报(医学版)》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨多重耐药鲍曼不动杆菌(multidrug resistant Acinetobacter baumannii,MDRAB)及非多重耐药鲍曼不动杆菌(non-multidrug resistant Acinetobacter baumannii,N-MDRAB)的外排泵表型、基因型和外排泵基因表达情况。方法应用K-B法将120株临床分离的鲍曼不动杆菌,分成MDRAB 96株和N-MDRAB 24株两组;参照Sylvia Valdezate方法检测鲍曼不动杆菌的外排泵表型,即采用微量肉汤稀释法,观察加入泵抑制剂羰基氰氯苯腙(CCCP)前后其MIC值的变化,筛选出加入泵抑制剂后MIC值比原值降低1/4倍或以上的菌株为AB外排泵表型阳性;PCR法扩增外排泵蛋白基因并测序进行序列分析。结果 96株MDRAB对β-内酰胺类、头孢菌素类、碳青霉烯类、氨基糖苷类、喹诺酮类、四环素类、磺胺类、多黏菌素类抗菌药物的耐药率分别为76.04%~92.71%、73.96%~97.92%、40.63%~42.71%、92.71%~98.96%、93.75%~98.96%、98.96%、79.17%、0。24株N-MDRAB对头孢菌素类、β-内酰胺类、碳青霉烯类、氨基糖苷类、喹诺酮类、四环素类、磺胺类、多黏菌素类抗菌药物的耐药率分别为16.52%~20.43%、11.22%~15.65%、0、17.83%~18.26%、20.43%~23.39%、14.78%、19.57%、0。外排泵抑制检测结果显示,96株MDRAB有34株外排泵阳性,外排泵基因检测有33株adeB、32株adeR、33株adeS、33株adeJ、0株adeE和33株abeM,检出阳性率分别为97.06%、94.12%、97.06%、97.06%、0、97.06%;24株N-MDRAB未检测到外排泵阳性菌株,但外排泵基因检测有12株adeB、20株adeR、16株adeS、18株adeJ、0株adeE和16株abeM,检出阳性率分别为50%、83.33%、66.67%、75%、0、66.67%。对adeB、adeR、adeS、adeJ、abeM基因进行测序,经比对,所测序列与GenBank中序列同源性为100%。结论外排泵基因广泛存在于MDRAB中,但在N-MDRAB中亦可以发现主动外排泵基因的存在。
[Abstract]:Objective to investigate the efflux pump phenotype, genotype and exudate pump gene expression of Acinetobacter baumanniiformis multidrug resistant Acinetobacter Baumanniien MDRAB and non-multidrug resistant Acinetobacter Baumannii N-MDRAB. Methods 120 clinical isolates of Acinetobacter baumannii were isolated by K-B method. MDRAB 96 strains and N-MDRAB 24 strains were divided into two groups. The phenotype of acinetobacter baumannii efflux pump was detected by Sylvia Valdezate method. The changes of MIC value before and after the addition of the pump inhibitor, carbonyl cyanochlorobenzene Hydrazone (CCCP), were observed by broth dilution method. The strains whose MIC value was 1/4 times lower than the original value after adding pump inhibitor were amplified by AB efflux pump phenotypic positive PCR method and sequenced. Results 96 strains of MDRAB were used to detect 尾 -lactams and cephalosporins, while 尾 -lactams, cephalosporins, 尾 -lactams, cephalosporins, 尾 -lactams and cephalosporins were detected by MDRAB. The drug resistance rates of carbapenems, aminoglycosides, quinolones, tetracyclines, sulfonamides and polymyxin antibiotics were 76.040.04, 92.711,73.921 and 40.63N, 42.71C, 99.969698.9698.9698.9698.969.969.960.24 N-MDRAB, respectively, to cephalosporins, 尾 -lactams, carbapenes, aminoglycosides, noxones, and so on, and the resistance rates of N-MDRAB to cephalosporins, 尾 -lactams, carbapenems, aminoglycosides, noxones were 79.170.24%, respectively, and the resistance rates of N-MDRAB to cephalosporins, 尾 -lactams, carbapenems, aminoglycosides, noones were 79.170.24%. The drug resistance rates of tetracycline, sulfanilamide and polymyxin antibiotics were 16.52U 20.43 and 11.22 / 15.65 respectively. The resistance rates of tetracycline, sulfanilamide and polymyxin were 17.83%, 18.26%, 20.43% and 23.39%, respectively. The results of the inhibition test of the efflux pump showed that 34 of the 96 strains of MDRAB were positive for efflux pump, and 34 strains were positive for efflux pump. There were 33 strains of adeBN, 33 strains of adeSN, 33 strains of adeSN, 0 strain adeE and 33 strains of abeM.The positive rates were 97.06% and 94.12%, 97.06% and 97.06%, respectively, and 24 strains of N-MDRAB were not detected positive for efflux pump. However, there were 12 strains of adeBX, 20 strains of adeBX, 16 strains of adeSN, 18 strains of adeJN, 0 strain adeE and 16 strains of abeM, the positive rates of which were 50 + 83.33% and 66.67%, respectively. The sequence of adeBadeRadeSadeJabeM gene was sequenced and compared with that of GenBank. Conclusion the efflux pump gene is widely distributed in MDRAB. However, the presence of active efflux pump gene can also be found in N-MDRAB.
【作者单位】：西安交通大学第二附属医院检验科;西北妇女儿童医院妇产科重症监护室;河北医科大学第一医院检验科;
【分类号】：R446.5

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