鲍曼不动杆菌PER型超广谱β内酰胺酶耐药基因研究
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刘文恩

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R378.99

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湖南省科技厅基金资助项目(08FJ3175)


Study on drug resistance genes of PERtype extendedspectrum βlactamases in Acinetobacter baumannii
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    摘要:

    目的探讨某院产PER型超广谱β内酰胺酶(ESBLs)鲍曼不动杆菌分子流行病学特点及耐药机制。方法选取该院2009年1—5月临床分离的非重复鲍曼不动杆菌129株,采用KB纸片扩散法进行药敏试验,聚合酶链反应(PCR)扩增PER基因并测序,肠杆菌科基因间重复一致序列(ERIC)PCR进行同源性分析。结果78株鲍曼不动杆菌携带PER1型基因,阳性率60.47%(78/129)。PER1阳性鲍曼不动杆菌对亚胺培南、美罗培南、氨苄西林/舒巴坦、米诺环素和头孢哌酮/舒巴坦的耐药率分别为46.15%、44.87%、38.46%、10.26%和8.97%,对其余10种抗菌药物的耐药率均>60%;PER1阳性菌株对头孢他啶、头孢噻肟、头孢吡肟、环丙沙星和左氧氟沙星的耐药率明显高于PER1阴性菌株(均P<0.05)。78株PER1阳性菌株包括7型,分别为A型(1株)、B型(1株)、C型(55株)、D型(18株)、E型(1株)、F型(1株)、G型(1株),C和D型为主要克隆型。结论C和D型PER1阳性鲍曼不动杆菌为该院最主要的流行株。产PER1型ESBLs鲍曼不动杆菌呈多重耐药,米诺环素、头孢哌酮/舒巴坦可作为该院鲍曼不动杆菌感染治疗的最佳选药。

    Abstract:

    ObjectiveTo investigate molecular epidemiological characteristics and antimicrobial resistance mechanism of PERtype extendedspectrum βlactamases (ESBLs)producing Acinetobacter baumannii(A. baumannii). Methods129 A.baumannii clinical strains isolated from a hospital between January and May 2009 were performed antimicrobial susceptibility testing by KirbyBauer disk diffusion method, PER gene was amplified by polymerase chain reaction (PCR),PCR amplified products of PER gene were sequenced, genotypes were identified by enterobacterial repetitive intergenic consensusPCR (ERICPCR).ResultsPER1 gene was detected in 78 of 129 clinical isolates, positive rate was 60.47%(78/129). The resistance rates of PER1positive strains to imipenem, meropenem, ampicillin/sulbactam, minocycline and cefoperazone/sulbactam was 46.15%, 44.87%, 38.46%, 10.26% and 8.97% respectively,the resistance rates to the other 10 kinds of antimicrobial agents were all >60%; The resistance rates of PER1positive strains to ceftazidime, cefotaxime, cefepime, ciprofloxacin, and levofloxacin were significantly higher than PER1negative strains (all P<0.05). 78 PER1positive strains were divided into 7 types, including type A(1), B(1), C(55), D(18), E(1), F(1), and G(1), of which the main clones were type C and D.ConclusionType C and D PER1positive A.baumannii are the main epidemic strains in this hospital. PER1type ESBLproducing A.baumannii strains are multidrug resistant, minocycline and cefoperazone/sulbactam are optimal antimicrobial agents for treating A. baumannii infection in this hospital.

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邓红丽,刘文恩,等.鲍曼不动杆菌PER型超广谱β内酰胺酶耐药基因研究[J]. 中国感染控制杂志,2014,13(3):129-133. DOI:10.3969/j. issn.1671-9638.2014.03.001.
DENG Hongli., LIU Wenen, CHEN Zhenhua, et al. Study on drug resistance genes of PERtype extendedspectrum βlactamases in Acinetobacter baumannii[J]. Chin J Infect Control, 2014,13(3):129-133. DOI:10.3969/j. issn.1671-9638.2014.03.001.

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  • 收稿日期:2013-08-30
  • 最后修改日期:2013-11-12
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  • 在线发布日期: 2014-03-30
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