| 2010年中国CHINET细菌耐药性监测 |
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| 引用本文： | 葛忆琳, 贾晔, 陈越火, 王臻, 陈泰尧, 毕菁, 沈伟. 医院重症监护室多耐药鲍曼不动杆菌耐药基因的流行特征[J]. 上海预防医学, 2019, 31(11): 911-917. DOI: 10.19428/j.cnki.sjpm.2019.19030 |
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| 作者姓名： | 葛忆琳 贾晔 陈越火 王臻 陈泰尧 毕菁 沈伟 |
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| 作者单位： | 上海市疾病预防控制中心，上海 200336 |
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| 摘 要： | 目的分析医院重症监护室临床病例与环境分离的鲍曼不动杆菌株携带多种耐药基因的相关性，探索多重耐药鲍曼不动杆菌携带的耐药基因特征与传播耐药基因的途径。方法采用微量肉汤稀释法(MIC)作药敏试验、聚合酶链式反应及基因测序。结果2013—2014年ICU临床病例标本分离的150株鲍曼不动杆菌对头孢类菌素、氨基糖苷类抗菌药物、庆大霉素耐药率在96%以上。环境标本分离的103株鲍曼不动杆菌对氨基糖苷类抗菌药物阿米卡星耐药率最高，达62.39%；对碳青霉烯类抗菌药物(亚氨培南、美罗培南)的耐药率为53.21%、55.96%。基因分析显示主动外排泵adBe阳性时，它分别与A类、D类β-内酰胺酶或A类、C类β-内酰胺酶基因、膜孔蛋白carO基因、氨基糖苷类基因等相关。carO基因与氨基糖苷类基因aph(3′)-Ι、aac(6′)-Ⅰb、D类β-内酰胺酶OXA-51, 66群、回旋拓普酶gyrA基因相关。结论携带adBe基因的鲍曼不动杆菌对常用抗菌药物产生多重耐药性具有重要作用；膜孔蛋白carO阳性, 介导碳青霉烯类药物的渗透, 要谨防新耐药基因的亚型出现，加强病区环境消毒与管理，有效阻断医院ICU多重耐药鲍曼不动杆菌传播。
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| 关 键 词： | 鲍曼不动杆菌 耐药基因 相关性 基因测序 |
| 收稿时间： | 2018-08-20 |
OXA beta-lactamase-mediated carbapenem resistance in Acinetobacter baumannii |
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| GE Yi-lin, JIA Ye, CHEN Yue-huo, WANG Zheng, CHEN Tai-yao, BI Jing, SHEN Wei. Epidemiological characteristics of multidrug-resistant genes of Acinetobacter baumannii in intensive care unit (ICU)[J]. Shanghai Journal of Preventive Medicine, 2019, 31(11): 911-917. DOI: 10.19428/j.cnki.sjpm.2019.19030 |
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| Authors: | GE Yi-lin JIA Ye CHEN Yue-huo WANG Zheng CHEN Tai-yao BI Jing SHEN Wei |
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| Affiliation: | Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China |
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| Abstract: | Objective To analyze the correlation between the clinical cases of the ICU and the environment, and to explore the characteristics of drug resistance genes carried by multidrug resistant Acinetobacter baumannii and its approach to transmit drug resistance genes.Methods The results of sequencing were analyzed by susceptibility test microdilution method MIC and polymerase chain reaction amplification.Some positive genes were sequenced.ResultsFrom March 2013 to March 2014, ICU cliamynical samples were used to isolate 150 strains of cephalosporins, aminoglycoside antibiotics, gentamycin, whose drugs resistance rate were above 96.00%.The resistant rate of 105 strains of Acinetobacter baumannii to aminoglycoside antimicrobial amikacin was up to 62.39%.The resistance rate to carbapenem antibiotics (imipenem, meropenem) was 53.21%, 55.96%.Analysis of drug resistance genes in clinical cases and environmental specimens showed that the active efflux pump adBe gene was expressed with the A, D-type β-lactamase or class A, C-β-lactamase gene, membrane porin carO Gene, aminoglycoside gene and so on.The expression of carO gene was correlated with aminoglycoside gene aph(3′)-Ι, aac(6′)-Ⅰb, D-type β-lactamase OXA-51, 66 group and cyclophosphate gyrA gene.There was a mutation in one of the gryA gene sequences of the isolates of the genus Acinetobacter.Conclusion It is proved that Acindetobacter baumannii carrying adBe gene plays an important role in producing multi-drug resistance in commonly used antibacterials. Membrane pore protein carO high expression, mediating penicillin penetration, is involved in multiple drug resistance to Acinetobacter baumannii.Therefore, we must beware of the emergence of subtypes of new drug resistance genes and strengthen the ward environment disinfection and management, that is an effective way to block the transmission of ICU multi-drug resistant Acinetobacter baumannii. |
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| Keywords: | Acinetobacter baumannii drug- resistance genes correlations gene sequencing |
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