鲍曼不动杆菌耐药性分析及产碳青霉烯酶状况的研究

发布时间：2018-11-04 08:55

【摘要】：目的:了解我院鲍曼不动杆菌的临床耐药情况、科室分布、耐药特点,以及耐药性变迁情况。探究耐碳青霉烯类鲍曼不动杆菌产碳青霉烯酶的情况。方法:利用回顾性方法对2012年-2015年检出鲍曼不动杆菌的耐药情况进行统计分析,并收集36株耐碳青霉烯类抗生素的菌株。利用改良Hodge试验对这些菌株进行碳青霉烯酶表型的确证,筛选出产碳青霉烯酶的菌株。利用PCR法检测碳青霉烯酶的基因型。结果:(1)鲍曼不动杆菌的耐药率逐年递增,对常用抗生素耐药率高,对碳青霉烯类抗生素的亚胺培南和美罗培南耐药率大于50%。(2)分离出的鲍曼不动杆菌主要来源于呼吸道标本共127株,占46.2%,其次为分泌物,共80株,占29.1%。以菌种科室分布而言,鲍曼不动杆菌主要来自于重症医学科,占37.9%,其次来自于呼吸内科,占13.8%。(3)检测出36株耐碳青霉烯类的菌株,改良Hodge试验后有34株呈阳性,经PCR扩增及产物电泳后检出32株携带有OXA-23基因,其余基因OXA-24、IMP-1、IMP-2、VIM-1、VIM-2未检出。结论:(1)我院分离的鲍曼不动杆菌耐药情况比较严重,细菌耐药率逐年递增。(2)鲍曼不动杆菌对碳青霉烯类耐药的情况严重,对亚胺培南和美罗培南的耐药率在50%以上。(3)我院鲍曼不动杆菌主要产OXA-23型碳青霉烯酶。未检测到IMP型、VIM型和OXA-24型碳青霉烯酶。
[Abstract]:Objective: to investigate the clinical drug resistance of Acinetobacter baumannii in our hospital. To investigate the production of carbapenem-resistant acinetobacter baumannii. Methods: the drug resistance of Acinetobacter baumannii from 2012 to 2015 was analyzed retrospectively and 36 strains resistant to carbapenem antibiotics were collected. The improved Hodge test was used to identify the carbapenem phenotypes of these strains and to screen the strains producing carbapenem. The genotypes of carbapenem were detected by PCR method. Results: (1) the drug resistance rate of Acinetobacter baumannii increased year by year, and the resistance rate of Acinetobacter baumannii to common antibiotics was high. The resistant rates of imipenem and meropenem to carbapenem antibiotics were more than 50. (2) the isolated Acinetobacter baumannii mainly originated from 127 strains of respiratory tract samples, accounting for 46.2%, followed by secretion (80 strains), accounting for 29.1%. Acinetobacter baumannii mainly came from the department of intensive medicine (37.9%), followed by respiratory department (13.881%). (3) 36 strains resistant to carbapenem were detected. After modified Hodge test, 34 strains were positive, 32 strains were detected by PCR amplification and product electrophoresis, 32 strains carried OXA-23 gene, while the other genes OXA-24,IMP-1,IMP-2,VIM-1,VIM-2 were not detected. Conclusion: (1) the drug resistance of Acinetobacter baumannii isolated in our hospital is serious, and the rate of bacterial resistance is increasing year by year. (2) Acinetobacter baumannii is more resistant to carbapenes. The resistance rates to imipenem and meropenem were over 50%. (3) Acinetobacter baumannii mainly produced OXA-23 carbapenem. No IMP, VIM and OXA-24 carbapenem was detected.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R446.5

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