泛耐药鲍氏不动杆菌耐药元件研究

发布时间：2019-02-13 20:19

【摘要】：目的探讨泛耐药鲍氏不动杆菌获得性耐药基因与可移动遗传、耐药元件的携带及关联性,为临床治疗提供参考依据。方法收集2014年住院患者中分离的20株泛耐药鲍氏不动杆菌,用mdfA测序确认菌种,再采用聚合酶链反应(PCR)及序列分析的方法,分析32种β-内酰胺类药物获得性耐药基因,对获得性耐药基因与可移动遗传元件标记测得结果作指标聚类分析。结果 20株泛耐药鲍氏不动杆菌共检出4种β-内酰胺类获得性耐药基因、1种膜孔蛋白基因、3种氨基糖苷类获得性耐药基因、1种外排泵泵蛋白基因、5种可移动遗传元件遗传标记,且阳性率非常高;blaOXA-23群和插入序列ISaba1的连锁检测均呈阳性;指标聚类分析提示β-内酰胺类获得性耐药基因blaTEM、blaADC、blaOXA-23群、blaOXA-51群,氨基糖苷类获得性耐药基因aph3′-Ⅰ与可移动遗传元件中的ISaba1、intⅠ1均高度相关;外排泵泵蛋白基因adeB与IS26高度相关,氨基糖苷类获得性耐药基因aac3-Ⅰ与tnpU、tnp513亦高度相关。结论泛耐药鲍氏不动杆菌中携带的耐药基因和耐药表型相对应,携带blaTEM、blaADC、blaOXA-23群、blaOXA-51群、膜孔蛋白基因carO2缺失、aph3′-Ⅰ及外排泵泵蛋白基因adeB,是泛耐药鲍氏不动杆菌对β-内酰胺类、氨基糖苷类、氟喹诺酮类耐药的重要原因。
[Abstract]:Objective to investigate the relationship between acquired drug resistance gene of Acinetobacter baumannii and mobile inheritance and drug resistance elements in order to provide reference for clinical treatment. Methods A total of 20 strains of pan-resistant Acinetobacter baumannii isolated from inpatients in 2014 were collected and identified by mdfA sequencing, and 32 尾 -lactam acquired drug resistance genes were analyzed by polymerase chain reaction (PCR) and sequence analysis. The results of acquired drug resistance gene and mobile genetic element markers were analyzed by cluster analysis. Results A total of 4 尾-lactam acquired drug resistance genes, 1 membrane pore protein gene, 3 aminoglycoside acquired drug resistance genes and 1 efflux pump protein gene were detected in 20 strains of pan-resistant Acinetobacter baumannii. 5 kinds of mobile genetic element genetic markers, and the positive rate is very high; The linkage tests of blaOXA-23 group and insertion sequence ISaba1 were positive. Cluster analysis showed that 尾 -lactam acquired drug resistance gene blaTEM,blaADC,blaOXA-23 group, blaOXA-51 group and aminoglycoside acquired drug resistance gene aph3'- 鈪，

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