广州三所医院鲍曼不动杆菌携带耐消毒剂基因及耐药基因的调查

目的 了解临床分离鲍曼不动杆菌携带耐消毒剂基因及耐药基因的情况.方法 收集广州地区3所三甲医院60株鲍曼不动杆菌,采用琼脂扩散法检测菌株对13种抗菌药物的药敏结果;聚合酶链反应（PCR）方法检测qacA/B、qacG、smr、qacEA1等4种耐消毒剂基因和Isabal、tnp513、PER-1和armA等4种耐药基因.结果 60株鲍曼不动杆菌主要见于重症监护病房（ICU）、烧伤科和呼吸内科,分别为33株（55.0％）、11株（18.3％）、8株（13.3％）,其余为重症监护病房1株（1.7％）、神经外科1株（1.7％）、其他6株（10.0％）.其中40株（66.7％）标本来自下呼吸道,另有创面分泌物9株（15.0％）、血7株（1 1.7％）、尿2株（3.3％）、引流物2株（3.3％）.60株鲍曼不动杆菌均为多重耐药菌,对亚胺培南、哌拉西林/他唑巴坦、头孢他啶、四环素、环丙沙星、阿米卡星和复方新诺明等抗菌药物耐药率分别为91.7％ （55/60）、98.3％（59/60）、98.3％（59/60） 、96.6％（58/60）、96.7％ （58/60）、78.3％ （47/60）和86.7％（52/60）,对其他抗菌药物耐药率大于70.0％;PCR结果显示,qacE△1、Isaba1、PER-1和armA基因阳性率分别为78.3％ （47/60） 、85.0％（51/60）、16.7％（10/60）和88.3％ （53/60）;qacA/B、qacG、tnp513和smr 4种基因检测结果为阴性.结论 鲍曼不动杆菌对广谱抗菌药物耐药严重,并携带了耐消毒剂基因.应规范此类抗菌药物的使用并采取相应的消毒措施防止多重耐药菌株在院内传播.

Investigation of antiseptics resistance genes and drug-resistant genes in acinetobacter banumannii from three hospitals in Guangzhou

Objective To investigate the antiseptics resistance genes and drug resistant genes in acinetobacter baumannii isolates.Methods In totally,60 strains of acinetobacter baumannii were randomly collected from three first-class hospitals at grade 3 in guangzhou.Agar diffusion method was used to determinate their sensitivity to 13 antibacterials; antiseptics resistance genes such as qacA/B,qacG,smr,qacE△1 and 4 kinds of drug resistant genes such as Isabal,tnp513,per-1 and armA were detected by PCR.Results In totally of 60 acinetobacter baumannii were mainly seen in the intensive care unit （ICU）,burn unit and department of Respiratory medicine respectively 33 （55.0％）,11 （18.3％）,8 （13.3％）,the rest of ICU 1 （1.7％）,neurosurgery 1 （1.7％）,the other six （10.0％）.Of which 40 （66.7％） specimens from the lower respiratory tract,and another wound secretions 9 （15.0％）,blood 7 （11.7％）,urinary 2 （3.3％）,drain 2 （3.3％）.Most isolates tested were multidrug resistance,the resistante rates to imipenem,piperacillin-tazobactam,ceftazidime,tetracycline,ciprofloxacin,amikaxin and trimethoprom-sulfamethoxazole were 91.7％ （55/60）,98.3％ （59/60）,98.3％ （59/ 60）,96.6％ （58/60）,96.7％ （58/60）,78.3％ （47/60） and 86.7％ （52/60）,other antimicrobial resitances were greater than 70％ ; PCR results showed that positive rate of qacE△1,Isabal,per-1 and armA gene were 78.3％ （47/60）,85.0％ （51/60）,16.7％ （10/60） and 88.3％ （53/60） respectively; four kinds of genetic test results sush as QacA/B,qacG,tnp513 and SMR were negative.Conclusions Acinetobacter baumannii strains have resistances to broad-spectrum antibiotic seriousiy and antiseptics resistance genes are carried.Accordingly,broad-spectrum antibiotics should be standardized utilized and effective disinfection measures should be carried out to prevent the dissemination of multidrug resistant strains in the hospital.