鲍曼不动杆菌多重耐药性与Ⅰ类整合子关系研究

发布时间：2018-05-24 23:39

本文选题：鲍曼不动杆菌 + 多重耐药性　；参考：《吉林大学》2012年硕士论文

【摘要】：鲍曼不动杆菌(Acinetobacter baumannii，AB)是一种常见的条件致病菌，广泛地分布于自然界和正常人体表面。据卫生部2010年全国细菌耐药监测网数据统计，鲍曼不动杆菌的临床分离率在革兰阴性菌中仅次于大肠埃希菌和铜绿假单胞菌，居第三位，该菌在重症监护病房（ICU）和急诊患者中分离率居革兰阴性菌首位。近年来，鲍曼不动杆菌的临床分离率呈上升趋势，并且对紫外线、消毒剂及常见抗生素均有明显的耐药性。临床上分离的鲍曼不动杆菌往往呈现多重耐药性，对多种抗生素的耐药率超过40%，尤其是对以往常用的较敏感的亚胺培南和头孢哌酮/舒巴坦耐药率呈逐年增高趋势。另外，鲍曼不动杆菌杆菌感染在年老体弱、ICU重症患者中往往表现出更强的耐药性，治疗困难，甚至威胁患者生命安全[1]，在全球范围内有播散现象，在有些地区甚至引起了爆发行流行[2][3]。因此对鲍曼不动杆菌的预防、控制、治疗已引起各国医疗和科研工作者的广泛关注。整合子是一种可移动的基因元件，存在于细菌染色体或质粒中，可携带多种耐药基因，通过整合、剪切这些耐药基因，将这些耐药基因串联在细菌基因组中，使细菌耐药性在同种细菌或不同种属细菌之间发生水平转移。整合子结构是细菌多重耐药性产生的重要原因之一。目前可根据整合酶的基因序列不同，，将整合子可分为6类,以I类整合子最常见[4]，在临床检测中具有重要意义。本研究通过对吉林大学中日联谊医院近几年临床分离的鲍曼不动杆菌进行耐药性分析，发现其耐药率呈逐年上升趋势，多重耐药现象（即对三种及以上的抗生素耐药）严重，收集2012年上半年90株鲍曼不动杆菌，PCR检测Ⅰ类整合子的分布情况，并对Ⅰ类整合子可变区耐药基因盒进行检测与序列分析，重点探讨Ⅰ类整合子与鲍曼不动杆菌多重耐药性的关系。
[Abstract]:Acinetobacter Baumannii AB (Acinetobacter baumannii) is a common conditional pathogen, widely distributed in nature and normal human body surface. According to the data of the national bacterial drug resistance surveillance network of the Ministry of Health in 2010, the clinical isolation rate of Acinetobacter baumannii was second only to Escherichia coli and Pseudomonas aeruginosa among gram-negative bacteria, ranking third. The isolation rate of this bacterium in ICU and emergency patients was the highest in Gram-negative bacteria. In recent years, the clinical isolation rate of Acinetobacter baumannii has increased, and has obvious resistance to ultraviolet rays, disinfectants and common antibiotics. The clinical isolates of Acinetobacter baumannii often show multidrug resistance, and the resistance rate to many antibiotics is more than 40%, especially to the more sensitive imipenem and cefoperazone / sulbactam, which were commonly used in the past. In addition, Acinetobacter baumannii infection tends to exhibit stronger drug resistance, difficulty in treatment and even threat to the life of patients in intensive care units (ICU). In some areas it has even caused an outbreak [2] [3]. Therefore, the prevention, control and treatment of Acinetobacter baumannii have attracted extensive attention of medical and scientific researchers all over the world. Integron is a transportable gene element that exists in a bacterial chromosome or plasmid and can carry a variety of drug-resistant genes, which are linked to the bacterial genome by integrating, splicing, and linking these resistant genes. The drug resistance of bacteria is transferred horizontally between the same bacteria or different species of bacteria. Integrated substructure is one of the important causes of multidrug resistance of bacteria. According to the gene sequence of integrase, integrons can be divided into 6 types, with class I integron being the most common [4], which is of great significance in clinical detection. In this study, the drug resistance of Acinetobacter baumannii isolated from the clinic of Jilin University Sino-Japanese Friendship Hospital in recent years was analyzed. It was found that the resistance rate of Acinetobacter baumannii increased year by year, and the phenomenon of multidrug resistance (i.e., resistance to three or more antibiotics) was serious. In the first half of 2012, 90 strains of Acinetobacter baumannii (Acinetobacter baumannii) were detected for the distribution of class I integron by PCR, and the gene cassette of variable region resistance of class I integron was detected and sequenced. The relationship between class I integron and multidrug resistance of Acinetobacter baumannii was discussed.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R378.991

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