医院获得性肺炎患者醋酸钙-鲍曼不动杆菌复合体的鉴定和耐药基因研究

发布时间：2018-02-28 02:51

本文关键词： 医院获得性肺炎醋酸钙-鲍曼不动杆菌复合体鲍曼不动杆菌碳青霉烯酶金属酶耐药　出处：《实用医学杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的:了解我院医院获得性肺炎患者下呼吸道分离的醋酸钙-鲍曼不动杆菌复合体的菌种鉴定方法和耐药性,探讨其耐药机制。方法:收集2009-2014年临床分离的醋酸钙-鲍曼不动杆菌复合体共318株,用K-B法进行药敏试验,用gyr B多重PCR法对其进行菌种鉴定,检测碳青霉烯酶及金属β-内酰胺酶耐药基因。结果:318株醋酸钙-鲍曼不动杆菌复合体鉴定为鲍曼不动杆菌298株、不动杆菌基因种型3为5株、不动杆菌基因种型13TU 8株。对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的不敏感率分别为78.0%、89%、92.1%。OXA型碳青霉烯酶基因OXA-51、OXA-23、OXA-24、OXA-58检出率分别为91.2%、65.7%、1.3%、3.8%;金属β-内酰胺酶基因IMP、VIM、GIM-1、SPM-1检出率分别为0.9%、34.6%、6.3%、0.9%;未检测到OXA-48、OXA-143、SIM-1、KPC、NDM-1等基因。结论:gyr B多重PCR法是一种快速、特异性高、可靠的鉴定鲍曼不动杆菌的方法。鲍曼不动杆菌对多种抗生素呈现高度耐药。我院鲍曼不动杆菌耐药性主要与OXA-23、VIM等耐药基因的表达有关。
[Abstract]:Objective: to investigate the identification methods and drug resistance of Acinetobacter baumannii complex isolated from lower respiratory tract of patients with nosocomial pneumonia in our hospital. Methods: 318 strains of Acinetobacter Acinetobacter Acinetobacter Actidis complex isolated from 2009 to 2014 were collected and. Results 298 strains of Acinetobacter baumannii and 5 strains of Acinetobacter Acinetobacter Acinetobacter were identified as the 3 strains of Acinetobacter Acinetogenes. Acinetobacter gene-type 13TU. For imipenem, cefoperazone / sulbactam, The insensitivity rates of piperacillin / tazobactam were 78.0 / 8989 and 92.1. OXA-51OXA-23OXA-24OXA-58, respectively; the insensitivity rates of piperacillin / tazobactam were 91.220.75; the detection rate of metal 尾 -lactamase gene IMPIM-GIM-1 SPM-1 was 0.90.34. 6; the OXA-48OXA-143SIM-1KPCNDM-1 and other genes were not detected. Conclusion the gyr B multiplex PCR method is a rapid and rapid method. Acinetobacter baumannii showed high resistance to many antibiotics. The drug resistance of Acinetobacter baumannii was mainly related to the expression of OXA-23 vim and other resistant genes.
【作者单位】：中山大学附属第三医院呼吸内科;中山大学生命科学学院;
【基金】：中山大学交叉学科资助计划项目(编号:A01586)
【分类号】：R446.5;R563.1

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