浙江省部分地区不动杆菌耐药性及耐药机制研究

发布时间：2018-01-23 08:49

本文关键词： 鲍曼不动杆菌耐药性碳青霉烯酶超广谱β内酰胺酶头孢菌素酶 ISAbal　出处：《浙江大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的：对浙江省5个地区5家医院临床分离的96株不动杆菌的耐药性及主要β内酰胺酶分布情况进行研究。方法：连续收集我省5个地区5家三级医院2009年2月起临床分离非重复不动杆菌共96株。应用PCR扩增blaOxa-51及16S-23S rRNA序列分析确定不动杆菌的基因种型；应用纸片扩散法测定所有菌株对13种抗菌药物的敏感性；应用琼脂稀释法测定多黏菌素B和多黏菌素E的最小抑菌浓度；应用PCR扩增及测序明确鲍曼不动杆菌中主要碳青霉烯酶基因、超广谱β内酰胺酶基因及头孢菌素酶基因的分布情况。结果： 96株不动杆菌分别为鲍曼不动杆菌(75株)、基因种型3(6株)和基因种型13TU(15株)；鲍曼不动杆菌对抗菌药物的耐药性要明显高于其他不动杆菌,其中鲍曼不动杆菌对亚胺培南和美罗培南的耐药率均为84.0%,其他不动杆菌中未发现亚胺培南和美罗培南耐药株；碳青霉烯类抗生素耐药鲍曼不动杆菌对其他抗菌药物耐药性强于碳青霉烯类抗生素敏感菌株；OXA-23是鲍曼不动杆菌携带的最主要碳青霉烯酶基因,且上游存在插入序列ISAbal;多数头孢他啶耐药鲍曼不动杆菌blampc上游存在插入序列ISAbal,而头孢他啶敏感菌株blampc上游未发现ISAbal. 结论：浙江省鲍曼不动杆菌耐药性严重,存在碳青霉烯类抗生素耐药鲍曼不动杆菌在多个地区广泛流行。多种耐药基因的存在是导致鲍曼不动杆菌耐药的重要原因。
[Abstract]:Objective: Drug resistance of 96 strains of Acinetobacter isolated from 5 hospitals in 5 regions of Zhejiang Province and distribution of major 尾 lactamases were studied. Methods: A total of 96 clinical isolates of Acinetobacter nonrepeated were collected from 5 tertiary hospitals in 5 regions of our province since February 2009. BlaOxa-51 and 16S-23S were amplified by PCR. The gene type of Acinetobacter was determined by rRNA sequence analysis. The susceptibility of all strains to 13 antimicrobial agents was determined by disk diffusion method. The minimal inhibitory concentrations of polymyxin B and polymyxin E were determined by Agar dilution method. The distribution of major carbapenase genes, extended-spectrum 尾 -lactamases and cephalosporinase genes in Acinetobacter baumannii was determined by PCR amplification and sequencing. Results: The 96 strains of Acinetobacter baumannii were 75 strains of Acinetobacter baumannii, 6 strains of gene species type (36 strains) and 15 strains of gene type 13TU. The antibiotic resistance of Acinetobacter baumannii to antimicrobial agents was significantly higher than that of other Acinetobacter baumannii. The resistance rates of Acinetobacter baumannii to imipenem and meropenem were both 84.0%. Imipenem and meropenem resistant strains were not found in other Acinetobacter. Carbapenem antibiotic resistant Acinetobacter baumannii was more resistant to other antimicrobial agents than carbapenem antibiotic sensitive strain. OXA-23 is the most important carbapenase gene carried by Acinetobacter baumannii, and the upstream insertion sequence is ISAbal. Most Ceftazidime resistant Acinetobacter baumannii (blampc) had insert sequence ISAbal. but Ceftazidime sensitive strain blampc did not find ISAbal. Conclusion: Acinetobacter baumannii (Acinetobacter baumannii) has serious drug resistance in Zhejiang province, and carbapenem antibiotic resistant Acinetobacter baumannii is widespread in many areas, and the existence of multiple resistance genes is the important cause of drug resistance of Acinetobacter baumannii.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R378

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