耐碳青霉烯鲍曼不动杆菌的耐药机制及分子流行病学

发布时间：2018-03-28 22:09

  本文选题：鲍曼不动杆菌　切入点：碳青霉烯耐药　出处：《中国抗生素杂志》2017年08期

【摘要】：目的碳青霉烯耐药鲍曼不动杆菌(CRAB)逐年升高的分离率和全球播散已成为极为严重的问题,本研究目的是阐明我院CRAB的耐药机制和分子流行病学特征。方法使用gyrB多重PCR方法将我院2014年7月—2015年6月分离的327株非重复醋酸钙-鲍曼不动杆菌复合体(ABC)鉴定到种,VITEK-2仪器法和E-test法测定抗菌药物的最低抑菌浓度(minimal inhibitory concentration MIC),PCR方法检测常见的碳青霉烯酶耐药基因、ISAba1并测序,Turton 2组多重PCR方法进行分子分型。结果327株ABC中有315株鲍曼不动杆菌(ABA)、9株皮特不动杆菌和3株医院不动杆菌,ABA、皮特和医院不动杆菌对亚胺培南的耐药率分别为91.7%、0和66.7%,耐药株主要分离自急诊科和呼吸ICU。ABA bla_(OXA-23-like)和ISAba1检出率均为91.1%,测序均为bla_(OXA-23),bla_(OXA-51-like)和ISAba1检出率分别为100%和0.3%,测序主要为bla_(OXA-66)和bla_(OXA-69),未检测到其他OXAs型、NDM、IMP、GIM、KPC、SIM、VIM和GES酶基因。Turton分子分型76.8%属于国际克隆Ⅱ型(IC Ⅱ)。结论携带bla_(OXA-23)和ISAba1的IC Ⅱ克隆是我院主要的流行克隆株,克隆播散是CRAB感染增加和暴发的重要原因。
[Abstract]:Objective the increasing isolation rate and global spread of carbapene-resistant Acinetobacter baumannii have become a serious problem. The aim of this study was to elucidate the mechanism of drug resistance and molecular epidemiological characteristics of CRAB in our hospital. Methods 327 strains of acinetobacter Acinetobacter Acinetobacter Acinetobacter Acetate isolated from July 2014 to. VITEK-2 instrument method and E-test method were used to determine the minimum inhibitory concentration minimal inhibitory concentration (MEC) of antimicrobial agents. Results the molecular typing was carried out by multiplex PCR method for the detection of the common carbapenem resistance gene (ISAba1) and sequencing Turton 2 groups. Results 31515 out of 327 ABC strains were detected by multiplex PCR. Acinetobacter baumannii 9 strains of Acinetobacter Pitt and 3 strains of Acinetobacter nosocomial ABA, Pitt and Acinetobacter nosocomial strains were resistant to imipenem 91.7% and 66.7% respectively. The resistant strains were mainly isolated from emergency department and respiratory ICU.ABA blastoid like (OXA-23-like) and ISAba1 detection rate. All of them were 91.1, and the detection rates of ISAba1 and ISAba1 were 100% and 0.3%, respectively, and the detection rates of OXA-51-like and ISAba1 were 100% and 0.3%, respectively, and the sequence was mainly OXA-66) and OXA-690.Conclusion No other OXAs type NDMPIMPIMPIMPIMGIMVIM and GES gene (.Turton) were detected. Conclusion\\\;\\\;\\\%)\% of the IC- 鈪，

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