消化科住院患者医院感染鲍曼不动杆菌外排泵系统机制研究及耐消毒剂基因检测分析

发布时间：2018-08-18 18:37

【摘要】：目的分析消化科患者感染鲍曼不动杆菌的外排泵系统机制及耐消毒剂基因分布情况,为患者的临床治疗及细菌耐药性发展的控制提供指导。方法分离自消化内科患者临床标本的鲍曼不动杆菌132株,采用K-B法进行耐药性分析。纯培养后挑取单菌落,加入到含有蛋白酶K溶液的离心管中,经水浴后离心,以设计的引物PCR扩增目的基因片段,观察耐药基因携带情况。结果 132株鲍曼不动杆菌中分离自痰液占71.97%、伤口分泌物占12.88%、脓液占6.82%、尿液占3.03%、其他标本占5.30%。K-B法测定132株鲍曼不动杆菌对阿米卡星、链霉素、庆大霉素、米诺环素、头孢吡肟、头孢噻肟、亚胺培南、美罗培南的耐药率分别为11.36%、55.30%、42.42%、34.85%、53.79%、61.36%、5.30%和10.61%。PCR检测鲍曼不动杆菌分离株的adeB基因大小为541bp,adeJ基因为453bp,abeM基因为781bp,adeR基因为447bp,adeS基因为544bp,检出率分别为38.64%、79.55%、40.91%、32.58%和51.52%;PCR检测鲍曼不动杆菌的耐消毒剂基因qacE△1基因大小为300bp,检出率为53.03%。结论消化内科患者感染的鲍曼不动杆菌对常用治疗药物均产生了一定程度的耐药性,这可能与菌株的外排泵系统基因及耐消毒剂基因携带率较高有一定关系。因此,及时进行细菌病原学及耐药性监测对于患者疾病治疗及控制细菌耐药性发展具有重要意义。
[Abstract]:Objective to analyze the mechanism of acinetobacter baumannii efflux pump system and the gene distribution of disinfectant resistance in patients in digestive department, so as to provide guidance for clinical treatment and control of bacterial drug resistance. Methods 132 strains of Acinetobacter baumannii were isolated from clinical samples of patients in internal digestive department and drug resistance was analyzed by K-B method. After pure culture, a single colony was selected and added to the centrifuge tube containing protease K solution. After centrifugation with water bath, the target gene fragment was amplified by designed primer PCR, and the drug resistance gene was observed. Results among the 132 strains of Acinetobacter baumannii, the sputum accounted for 71.97, the wound secretion 12.88, the pus 6.82, the urine 3.03.The other strains were measured by 5.30%.K-B for amikacin, streptomycin, gentamycin, minocycline, cefepime. Cefotaxime, imipenem, The drug resistance rates of meropenem were 11.36 and 55.30%, respectively. The detection rates were 38.6445% and 51.365.30%, respectively. The adeB gene size of Acinetobacter baumannii isolates detected by 10.61%.PCR was 541bpnnadeJ because 453bppnabeM was 451bpadeS because of 447bpadeS, and the detectable rate was 38.644559.5540.91b, 32.58% and 51.52U, respectively, to detect the sterilizing resistance of Acinetobacter baumannii. The size of qacE 1 gene was 300 BP, and the detection rate was 53.03. Conclusion Acinetobacter baumannii infected by patients with digestive internal medicine has a certain degree of drug resistance to common therapeutic drugs, which may be related to the high carrying rate of the genes of the efflux pump system and the disinfectant resistant genes of the strains. Therefore, timely monitoring of bacterial pathogens and drug resistance plays an important role in the treatment of patients and the control of bacterial drug resistance.
【作者单位】：齐齐哈尔医学院附属第三医院消化一科;
【分类号】：R382.31

【相似文献】