慢性重型肝炎患者痰泛耐药鲍曼不动杆菌39种耐药相关基因的研究

目的研究慢性重型肝炎患者痰泛耐药鲍曼不动杆菌39种耐药相关基因。方法应用法国梅里埃公司的API鉴定条／PSE5．0药敏条和美国BD公司的Phoenix NMIC／ID-109鉴定／药敏板鉴定和细菌药敏试验，应用PCR法检测分离于慢性重型肝炎患者合格痰标本1株泛耐Ab临床分离株29种β-内酰胺酶相关基因（bla）、6种氨基糖甙类修饰酶基因（AMEs）、消毒剂／磺胺耐药基因（qacE△1-sull）、3种整合子基因（intl1、2、3）等39种耐药相关基因，分析其分布情况。结果本株菌7种耐药相关基因阳性（二种bla基因（blaTEM、blaADC）、三种AMEs基因（aac（6′）-Ib、aac（3）-Ⅰ、ant（3″）-Ⅰ、qacE△1-sul1和Ⅰ类整合子基因（intIl））；其它27种bla基因、3种AMEs基因（aac（6′）-Ⅱ、aac（3）．Ⅱ）、ant（2″）-Ⅰ和2种整合子基因（intI2、intI3）均为阴性。结论本株泛耐菌耐药机制为多重机制，主要与7种耐药相关基因（blaTEM、blaADC、aac（6′）-Ib、aac（3）-Ⅰ、ant（3″）-Ⅰ、qacE△1-sull和Ⅰ类整合子）有关。经检索中文生物医学期刊文献数据库（CMCC）和medline数据库，本研究是泛耐Ab检测耐药相关基因最多的报道。

Study on 39 types of resistant-related genes in a pan-resistant Acinetobacter baumannii in the sputums from a severe chronic hepatitis patient

Objective To study 39 kinds of resistant- -related genes in a pan-resistant Acinetobacter baumannii in the spntums from a severe hepatitis B patient. Methods To detect the susceptibility of antimicrobial agents by MIC, 39 resistant-related genes including 29β-lactamases genes, 6 aminoglycosidemodifying enzymes （AMEs） genes, chlorhexidine-sulfaciazine resistant gene （qacE△1- sul1 ） and intergron （intI1,2.3 ）, et., of 1 strain of Acinetobacter baumannii in the sputums from a severe hepatitis B patient were measured by PCR, and verificated by DNA sequencing. Results In the strain, there were positive of 7 kinds of resistant-related genes （blaTEM, blaADC, aac（6′）-Ⅰb, aac（3）-Ⅰ, ant（3＂）-Ⅰ, qacE△I-sull, intI1）. 27 kinds genes of β-lactamases genes, 3 kinds genes of AMEs （aac（6′）- Ⅱ, aac（3）- Ⅱ, ant（2＂）- Ⅰ ）, 2 kinds genes of intI （intI2 and intI3） are negative. Conclusions The pan-resistant Acinetobacter baumannii is multiresistant and the mechanisms mainly are related to 7 kinds of resistant-related genes （blaTEM, blaADC, aac（6′）- Ⅰ b, aac（3）- Ⅰ , ant（3＂）- Ⅰ, qacE△1- sull, and intI1）.