鲍曼不动杆菌耐药性及碳青霉烯酶的研究

目的了解鲍曼不动杆菌耐药谱及碳青霉烯酶的研究。方法用VITEK60型全自动药敏分析系统鉴定药敏系统及纸片扩散法进行药敏实验;PCR扩增和测序分析检测碳青霉烯酶VIM、IMP、OXA-23和OXA-24。结果217株鲍曼不动杆菌中头孢哌酮/舒巴坦耐药率最低,其次是亚胺培南,再者是头孢他啶和哌拉西林/他唑巴坦;头孢哌酮/舒巴坦和头孢他啶的中介率分别是27.6%和19.8%;20株亚胺培南耐药菌中,PCR扩增VIM、IMP和OXA-24均阴性;OXA-23基因扩增显示19株（95%）阳性,PCR产物并经序列分析证实为OXA-23。结论碳青霉烯类抗生素的长期广泛应用使鲍曼不动杆菌的耐药率不断升高;产OXA-23型β-内酰胺酶是本院鲍曼不动杆菌对亚胺培南耐药的重要原因。

The resistant characteristic and carbapenemases in acinetobacter baumannii

Objective To investigate the resistant characteristic and carbapenemases in aeinetobacter Baumannii（Ab）. Methods Identification and analyses all specimens were identified by VITEK- 60, drug resistances were detected by VITEK- 60 , the drug resistance to SCF were detected by Kirby -Bauer test. PCR and DNA sequencing were performed to determine VIM, IMP, OXAo23 and OXA-24 β-lactamase. Results 217 strains, the resistance rate to sulperazone in 217 strains is the lowest, then to the Imipem＇ s ;The mid-drug-resistance rate of the sulperazone is 27. 6%, and the ceftazidime＇ s is 19. 8%. Of the 20 imipenem resistance strains, VIM,IMP and OXA-24 13-1actamase genotype were all negative, PCR and sequencing found 19 strains （95%） produced OXA-23. Conclusion The resistance rates is increasing to advance as longer-term or broad to use carbopenem; OXA-23 production is the important resistance mechanism in Imipenem.