鲍曼不动杆菌耐药性及氨基糖苷类耐药基因检测及分析

目的 探讨医院内鲍曼不动杆菌分离菌株氨基糖苷类耐药基因存在情况以及药物敏感性,指导临床合理应用抗生素.方法 采用法国梅里埃VITEK2 COMPACT全自动微生物分析仪对临床标本进行细菌鉴定和药物敏感试验.聚合酶链反应（PCR）检测aac（3）-Ⅰ,aac（3）-Ⅱ,aac（6′）-Ⅰ,aac（6′）-Ⅱ四种氨基糖苷类修饰酶耐药基因.结果 共分离鉴定出36株鲍曼不动杆菌,药敏结果显示分离菌株呈现多重耐药,耐药性最低为多粘菌素,未检测到耐药菌株;其次为亚胺培南,耐药率为55%;其余抗生素耐药率均在86%以上.耐药基因检测显示aac（3）-Ⅰ阳性11株,占30.6 %,aac（3）-Ⅱ阳性 12 株,占33.3 %,aac（6′）-Ⅰ阳性15株,占41.7 %,aac（6′）-Ⅱ未检测出.常见的基因组合为aac（3）-Ⅰ与aac（6′）-Ⅰ同时阳性,占36.4%.结论 鲍曼不动杆菌临床分离株耐药现象严重,aac（3）-Ⅰ,aac（3）-Ⅱ与aac（6′）-Ⅰ耐药基因携带率较高.

Drug resistance of A. Baumanii and aminoglycoside drug resistance gene detection and analysis

Objective To investigate the drug suseeptibility of A. baumanii and its resistant gene against aminoglvcnside so as to guide clinic to rationally use antibiotics. Method Drug sensitive test and identification of clinical isolates were performed by using France Merieux V/TEK2 COMPACT automatic microorganism instrument.The genes of aac（3） - I, aac（3） - II,aac（6＇） - I,aae（6＇） - II were detected by polymerase chain reaction（ PCR）. Result 36 strains of baumannii shows multi - drug resistance. The resistance rate was 55.5 % in imipenem. The other antibacterial agents were all above 86.0%. But all of isolateds were sensitive to cllostin E. The result of three aminoglycoside modi- fying genes detection showed that the positive rates of aac（3 ） - I, aac（3 ） - II, aac（6＇ ） - I were 30.6% ,33.3 % and 41.7% ,respectively and aac（6＇） - II was not detected in 36 straines. Conclusion A. baumanii showed severe antibiotics. There were high positive percentage of genes aac（3） - I, aac（3） - I1 and aae（6＇） - I.