烧伤患者感染产ESBLs鲍曼不动杆菌的耐药特性及耐药基因型分析

发布时间：2018-01-27 11:22

本文关键词： 烧伤鲍曼不动杆菌超广谱β-内酰胺酶耐药性基因型　出处：《中国病原生物学杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的分析烧伤患者感染产超广谱β-内酰胺酶(ESBLs)鲍曼不动杆菌的耐药特性及其耐药基因类型。方法采用纸片扩散法(KB法)测定分离自烧伤患者临床标本的137株鲍曼不动杆菌中产ESBLs菌株对β-内酰胺类抗生素的耐药特征,应用聚合酶链反应(PCR)进行细菌的ESBLs基因分型。结果 37株鲍曼不动杆菌对β-内酰胺类抗生素呈不同程度的耐药。检出产ESBLs菌84株,占61.31%。产ESBLs菌株对哌拉西林、替卡西林、氨苄西林/舒巴坦、头孢噻肟、头孢曲松、头孢他啶、头孢吡肟、氨曲南的耐药率分别为83.33%、88.10%、96.43%、89.29%、85.42%、86.90%、77.38%和89.29%,与非产ESBLs菌株耐药率50.94%~77.36%比较差异有统计学意义(P0.05);30株产ESBLs菌株中,仅携带TEM、SHV、OXA-23及PER型基因的分别有12株(40.00%)、4株(13.33%)、7株(23.33%)和2株(6.67%),其余5株中有3株(10.00%)同时携带TEM和OXA-23型两种基因,2株(6.67%)同时携带TEM、OXA-23和PER型3种基因。结论烧伤患者感染的产ESBLs鲍曼不动杆菌具有多重耐药性,耐药基因型包括TEM、SHV、OXA-23和PER型。
[Abstract]:Objective to analyze the drug resistance and gene types of Acinetobacter baumannii infected with extended-spectrum 尾 -lactamase (ESBLs) in burn patients. The resistance of 137 strains of Acinetobacter baumannii to 尾 -lactam antibiotics was determined. Application of polymerase chain reaction (PCR). Results 37 strains of Acinetobacter baumannii were resistant to 尾 -lactam antibiotics to varying degrees. 84 strains of ESBLs producing bacteria were detected. The ESBLs producing strains were piperacillin, tekassim, ampicillin / sulbactam, cefotaxime, ceftriaxone, ceftazidime, cefepime. The drug resistance rate of aztreonam was 83.33% and 88.10% and 96.43%, 89.29%, 85.42% and 86.90%, 77.38% and 89.29%, respectively. There was a significant difference between the drug resistance rate of 50.94% and non-producing ESBLs strain (77.36%). Among the 30 ESBLs producing strains, 12 strains only carry the OXA-23 gene and the PER type gene, respectively. 7 strains (23. 33) and 2 strains (6. 67) and 3 of the other 5 strains (10. 00) carried both TEM and OXA-23 genes. Two strains of Acinetobacter baumannii (6.67) carry three genes of Tem OXA-23 and PER. Conclusion Acinetobacter baumannii infected by burn patients has multiple drug resistance. The genotypes of drug resistance include Tem SHV A 23 and PER type.
【作者单位】：东南大学中大医院烧伤整形外科;江苏省中医药研究院;
【分类号】：R446.5;R644
【正文快照】： 鲍曼不动杆菌(Acinetobacter baumannii,Ab)是引发医院感染的重要病原菌,在非发酵菌中的临床分离率仅次于铜绿假单胞菌。临床上鲍曼不动杆菌感染主要发生于重症监护病房(ICU)衰竭患者、呼吸科感染患者以及各种有创伤伤口和创面感染的患者[1]。烧伤患者常由于存在广泛、严重的

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