鲍曼不动杆菌耐药性及生物膜相关基因的检测分析

发布时间：2018-05-26 23:01

本文选题：耐药性 + 鲍曼不动杆菌　；参考：《青岛大学》2017年硕士论文

【摘要】：目的了解山东省成武县人民医院鲍曼不动杆菌临床分离菌株的分布特点、耐药现状与耐药谱特征,并检测鲍曼不动杆菌aba I基因的携带情况,分析其阳性携带与临床分离菌株耐药性的关系。方法收集2012年10月至2013年10月山东省成武县人民医院分离出的70株鲍曼不动杆菌,采用K-B纸片法检测菌株的耐药特点,采用PCR技术扩增其生物膜合成相关基因,检测鲍曼不动杆菌临床分离菌株基因携带情况。结果(1)70株鲍曼不动杆菌临床分离毒株中,有40株(57.14%)为多重耐药菌株,6株(8.57%)是泛耐药菌株。(2)鲍曼不动杆菌分离菌株对临床常用的15种抗菌药物存在普遍耐药情况。鲍曼不动杆菌分离菌株耐药率最低的抗菌药为亚胺培南和阿米卡星,耐药率分别为30.00%和32.86%;其次是美罗培南和头胞吡肟,耐药率分别是38.57%和41.43%;对头孢曲松、哌拉西林、头孢呋辛的耐药率较高,分别为78.57%和78.57%、85.71%;对其余抗菌药物的耐药率均超过50.00%。(3)70株鲍曼不动杆菌中,47株aba I基因阳性,阳性率为67.14%;aba I基因阳性分离菌株的耐药率明显高于阴性菌株。(4)70株鲍曼不动杆菌中,52株int I1基因阳性,阳性率为74.29%;int I1基因阳性分离菌株的耐药率明显高于阴性菌株。(5)70株鲍曼不动杆菌中,csu C,csu D,csu E基因检出率分别为70.00%,78.57%和72.86%,基因阳性分离菌株对15种抗菌药物的耐药率大多高于阴性菌株,但多无统计学意义。结论(1)鲍曼不动杆菌临床分离菌株耐药率较高,其中对亚胺培南、阿米卡星以及美罗培南和头胞吡肟的耐药率较低,可作为治疗鲍曼不动杆菌感染的选择用药。(2)鲍曼不动杆菌主要感染部位为呼吸道,主要分布科室为重症医学科和呼吸科。(3)鲍曼不动杆菌临床分离菌株生物膜相关基因aba I和int I1检出率高,其在鲍曼不动杆菌多重耐药机制中起重要作用。
[Abstract]:Objective to investigate the distribution characteristics of Acinetobacter baumannii clinical isolates in Chengwu County people's Hospital of Shandong Province, the present situation of drug resistance and the characteristics of drug resistance spectrum, and to detect the carrying of Acinetobacter baumannii aba I gene. To analyze the relationship between its positive carrying and drug resistance of clinical isolates. Methods from October 2012 to October 2013, 70 strains of Acinetobacter baumannii isolated from people's Hospital of Chengwu County, Shandong Province were collected. K-B disk method was used to detect the drug resistance of the strain, and PCR was used to amplify the genes related to biofilm synthesis. To detect the gene carriers of Acinetobacter baumannii clinical isolates. Results of the 70 clinical isolates of Acinetobacter baumannii, 40 strains (57.14) were multidrug resistant strains (6 strains, 8.57%) were pan-resistant strains. (2) Acinetobacter baumannii isolates showed universal resistance to 15 kinds of antimicrobial agents commonly used in clinic. The antimicrobial resistance rates of Acinetobacter baumannii isolates were imipenem and amikacin, which were 30.00% and 32.86 respectively, followed by meropenem and cephalpyridoxime, with resistance rates of 38.57% and 41.43%, respectively, for ceftriaxone, piperacillin, ceftriaxone and piperacillin. The drug resistance rate of cefuroxime was 78.57% and 78.57%, respectively, and the resistance rate to other antimicrobial agents was higher than that of 50.00.30.The aba I gene of 47 strains of Acinetobacter baumannii was positive, and the resistance rate of cefuroxime was 78.57% and 85.71%, respectively. The positive rate of int I1 gene was significantly higher in the positive strains 67.14A than in the negative strains. 52 strains of Acinetobacter baumannii strains were positive for the int I1 gene, and the positive rate was higher than that of the negative strains of Acinetobacter baumannii. The positive rate was 74.29% and 72.86%, respectively. The rate of drug resistance of positive isolates was significantly higher than that of Acinetobacter baumannii (70.0078.57%) and positive isolates (72.86%), respectively. The resistance rate of positive isolates to 15 antimicrobial agents was higher than that of Acinetobacter baumannii strains. More than negative strains, But there is no statistical significance. Conclusion the drug resistance rate of Acinetobacter baumannii clinical isolates is high, and the resistance to imipenem, amikacin, meropenem and cephalopime is lower. Acinetobacter baumannii can be used as an alternative drug for treatment of Acinetobacter baumannii infection. The main infection site of Acinetobacter baumannii is respiratory tract. The detection rate of biofilm-associated genes aba I and int I1 in Acinetobacter baumannii clinical isolates was high, which played an important role in the mechanism of multidrug resistance of Acinetobacter baumannii.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R446.5

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