多重耐药鲍曼不动杆菌β-内酰胺类耐药基因研究

目的了解β-内酰胺类耐药基因在某院临床分离的多重耐药鲍曼不动杆菌(MDRAB)中的流行情况。方法对该院临床分离的22株MDRAB进行药敏试验,同时,采用聚合酶链反应(PCR)技术对其进行β-内酰胺类耐药基因(TEM、SHV、CTX-M、PER、DHA、IMP、VIM、SIM、OXA-23、OXA-24、OXA-58)检测。结果 22株MDRAB对头孢他啶、头孢噻肟、头孢吡肟、庆大霉素、阿米卡星、环丙沙星和复方磺胺甲口恶唑耐药率均为100.00%;对亚胺培南、美罗培南、头孢哌酮/舒巴坦的耐药率分别为50.00%、40.91%、31.82%,中介率分别为31.82%、36.36%、31.82%。22株(100.00%)MDRAB均携带耐药基因OXA-23群,16株(72.73%)携带TEM,12株(54.55%)携带IMP,4株(18.18%)携带PER;SHV、CTX-M、DHA、VIM、SIM、OXA-24群、OXA-58群基因检测均为阴性。结论携带IMP、TEM、PER、OXA-23耐药基因是导致该院MDRAB对β-内酰胺酶类抗生素耐药的重要机制。

Study on drug resistance genes for β lactams in multidrug resistant Acinetobacter baumannii

ObjectiveTo investigate prevalence of resistance genes for β lactams in clinically isolated multidrug resistant Acinetobacter baumannii (MDRAB) in a hospital.Methods22 clinically isolated MDRAB strains were performed antimicrobial susceptibility testing, resistance genes for β lactams (TEM, SHV, CTX M, PER, DHA, IMP, VIM, SIM, OXA 23, OXA 24, and OXA 58) in these strains were detected with polymerase chain reaction.ResultsThe resistant rates of 22 isolates of MDRAB to ceftazidime，cefotaxime，cefepime， gentamycin， amikacin，ciprofloxacin，and compound sulfamethoxazole were all 100.00%;to imipenem, meropenem,and cefoperazone / sulbactam were 50.00%,40.91%, and 31.82% respectively, intermediated rates were 31.82%,36.36%, and 31.82% respectively. The carriage rates of OXA 23, TEM, IMP, and PER were 100.00% (n=22), 72.73 % (n=16), 54.55% (n=12), and 18.18%(n=4) respectively.Detection results of SHV,CTX M,DHA,VIM,SIM, OXA 24,and OXA 58 were all negative.ConclusionCarriage of IMP, TEM, PER, and OXA 23 resistance genes are the major resistance mechanisms of MDRAB to β lactamase antimicrobial agents in this hospital.