鲍曼不动杆菌耐药监测及氨基糖苷修饰酶基因分布

目的 了解该院鲍曼不动杆菌的耐药状况和主要氨基糖苷修饰酶基因的分布情况。方法 用K-B法检测鲍曼不动杆菌的药敏情况，用PCR法检测选取的25株菌氨基糖苷修饰酶耐药基因的分布。结果 亚胺培能敏感率为98．3％，其次是头孢哌酮／舒巴坦、阿米卡星和头孢吡肟，分别为48．6％、44．2％和41.1％。阿米卡星耐药株占43．3％，且呈多重耐药性，与敏感株之间的耐药性有显著差别。15株阿米卡星耐药株均有aacA4基因，13株有aacC1和aadA基因，另外2株含有aphA1基因；10株阿米卡星敏感株均不含有4种待测耐药基因。结论 该院鲍曼不动杆菌的耐药性相当严重，aacA4、aacC1和aadA1氨基糖苷修饰酶耐药基因在多重耐药的鲍曼不动杆菌中普遍存在，aphA1阳性菌则少见。

Surveillance of antibiotics resistance and distribution of aminoglycoside-modifying enzymes in Acinetobacter baumanii

Objective To investigate the antibiotics resistance of Acinetobacter baumanii and distribution of aminoglycoside-modifying enzymes genes in our hospital.Methods Acinetobacter baumanii antibiotic susceptibility tests were performed by K-B method,and 25 strains of isolated Acinetobacter baumanii were detected by PCR assay for aminoglycoside-modifying enzymes genes.Results The Acinetobacter baumanii susceptibility to imipenem,cefoperazone/sulbactam,amikacin and ceftazidime was 98.3%,48.6%,44.2% and 41.1% respectively.The amikacin resistant strains accounted for 43.3% and were multi-resistent.There was significant difference of resistance between amikacin-resistant strains and susceptive ones.15 strains of amikacin-resistant Acinetobacter baumanii all carried aacA4 gene,13 strains carried aacC1 and aadA genes,other 2 strains carried aphA1,and 10 strains amikacin susceptive Acinetobacter baumanii didn't carry any gene above.Conclusion Resistence of Acinetobacter baumanii in our hospital is very serious,aacA4,aacC1 and aadA1 aminoglycoside-modifying enzymes genes exist in multi-resistent Acinetobacter baumanii widely,but aphA gene is less.