吴江地区多重耐药鲍曼不动杆菌碳青霉烯酶基因携带情况及同源性
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马春芳

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R181.3+2 R378.99

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吴江第一人民医院基金资助项目(201417)


Carriage and homology of carbapenemase genes of multidrugresistant Acinetobacter baumannii in Wujiang
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    摘要:

    目的了解吴江地区临床分离多重耐药鲍曼不动杆菌(MDRAB)碳青霉烯酶基因携带情况和同源性。方法收集吴江地区3所综合性医院2010年1月—2013年12月临床分离的非重复MDRAB 44株,测定其最低抑菌浓度(MIC);采用聚合酶链反应(PCR)扩增碳青霉烯酶基因OXA51、OXA23、OXA24、OXA58、IMP、TEM、SHV和GES,脉冲场凝胶电泳(PFGE)分析菌株同源性。结果44株MDRAB主要来源标本为痰(占93.18%),主要分布在重症监护病房(ICU)、呼吸科和神经外科,各占45.45%、27.27%和13.64%;MDRAB对米诺环素和多粘菌素B均敏感,对哌拉西林、氨苄西林/舒巴坦、头孢他啶、庆大霉素、阿米卡星、环丙沙星耐药率均为100.00%,对亚胺培南和美罗培南耐药率均为97.73%。44株MDRAB均检出OXA51、OXA23和TEM基因,其中12株菌GES基因阳性,OXA58和SHV基因阳性各1株,未检测到OXA24及IMP基因;MDRAB分为A—G 7个型别,分别为19、3、9、3、1、4、5株。A型主要来源于吴江地区的两所大型综合性医院(吴江第一人民医院和盛泽医院),吴江第一人民医院未发现B、D和E型;E型仅1株,分布在永鼎医院,其余型别散在分布。结论吴江地区临床分离鲍曼不动杆菌多重耐药严重,基因OXA23和TEM是鲍曼不动杆菌多重耐药的主要原因,并以A、C型为主,呈克隆性传播。

    Abstract:

    ObjectiveTo investigate the carriage and homology of carbapenemase genes of multidrugresistant Acinetobacter baumannii (MDRAB) in Wujiang area.MethodsA total of 44 nonduplicated MDRAB isolated from patients in 3 general hospitals in Wujiang area from January 2010 to December 2013 were collected. Minimum inhibitory concentrations(MICs) were detected, carbapenemase genes OXA51, OXA23, OXA24, OXA58, IMP, TEM, SHV, and GES were amplified with polymerase chain reaction(PCR), homology of strains was detected with pulsedfield gel electrophoresis(PFGE).Results44 MDRAB strains were mainly collected from sputum (93.18%), mainly distributed in intensive care unit (ICU), department of respiratory diseases, and department of neurosurgery, accounting for 45.45%, 27.27%, and 13.64% respectively; MDRAB were both sensitive to minocycline and polymyxin B, resistance rates to piperacillin, ampicillin/sulbactam, ceftazidime, gentamicin, amikacin, and ciprofloxacin were all 100.00%, resistance rates to imipenem and meropenem were both 97.73%. 44 MDRAB strains were all detected OXA51, OXA23 and TEM genes, 12 strains were positive for GES gene, 1 strain was positive for OXA58 and SHV respectively, OXA24 and IMP genes were not found ; MDRAB were divided into 7 types of GA, which included 19, 3, 9, 3, 1, 4, and 5 strains respectively, type A was mainly from two large general hospitals in Wujiang area (Wujiang First People’s Hospital and Shengze Hospital), type B, D and E strains were not detected in Wujiang First People’s Hospital, type E strain was only 1 isolate and was from Yongding Hospital, the other types were sporadically distributed.ConclusionMultidrug resistance of clinically isolated Acinetobacter baumannii is serious in Wujiang area, OXA23 and TEM genes are major causes of multidrug resistance in Acinetobacter baumannii, the main types are A and C, which present clonal spread.

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朱善军,倪晓艳,吴巧珍,等.吴江地区多重耐药鲍曼不动杆菌碳青霉烯酶基因携带情况及同源性[J]. 中国感染控制杂志,2016,15(12):913-916. DOI:10.3969/j. issn.1671-9638.2016.12.004.
ZHU Shanjun, NI Xiaoyan, WU Qiaozhen, et al. Carriage and homology of carbapenemase genes of multidrugresistant Acinetobacter baumannii in Wujiang[J]. Chin J Infect Control, 2016,15(12):913-916. DOI:10.3969/j. issn.1671-9638.2016.12.004.

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  • 收稿日期:2016-03-20
  • 最后修改日期:2016-06-12
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  • 在线发布日期: 2016-12-30
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