呼吸ICU耐碳青霉烯类鲍曼不动杆菌耐药基因的携带情况及同源性
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海南省自然科学基金(814307)


Carriage of drug resistance genes and homology of carbapenemresistant Acinetobacter baumannii isolated from respiratory intensive care unit
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    摘要:

    目的了解我院呼吸ICU耐碳青酶烯类鲍曼不动杆菌(CRAB)携带的β内酰胺酶的耐药基因及其流行特征。方法收集2015 年10—12月呼吸ICU临床患者送检标本分离的CRAB。试验菌株进行5种耐药基因(KPC2、IMP、VIM、NDM1、OXA23)PCR特异性扩增,扩增产物进行琼脂糖凝胶电泳和测序分析,并且进行脉冲场凝胶电泳(PFGE)同源性分析。结果2015年10—12月呼吸ICU共分离CRAB 22株,其中19株(86.36%)分离于痰。22株CRAB对复方磺胺甲口恶唑的耐药率为59.09%,对米诺环素的耐药率为9.09%,对多粘菌素B均敏感,对其他检测抗菌药物的耐药率均为80%以上。PCR扩增未检出KPC2、IMP、NDM1三种耐药基因,而VIM、OXA23阳性率均为100%。PFGE同源性分析结果:22株菌分为13种不同带型,每种带型包含菌株数为1~5株不等,其中9种带型(69.23%)分别只包含1株菌,其他4种(30.77%)带型包含菌株数为2~5株不等。其中,A5、A7和A8 为同一型,A9、A11、A14、A19和A22 为同一型, A4、A10和A12为同一型,A16和A18为同一型。结论呼吸ICU分离CRAB携带的β内酰胺酶耐药基因主要为VIM、OXA23型基因。同源性分析证实,有小部分为同一克隆株,存在小范围的流行。

    Abstract:

    ObjectiveTo investigate drug resistance genes and epidemic characteristics of βlactamase carried by carbapenemresistant Acinetobacter baumannii(CRAB) in the respiratory intensive care unit(RICU) in a hospital.MethodsClinically isolated CRAB from RICU patients in OctoberDecember 2015 were collected. Five drug resistance genes (KPC2, IMP, VIM, NDM1, OXA23) were specifically amplified by polymerase chain reaction (PCR), amplified products were performed agarose gel electrophoresis and sequencing analysis, the homology was analyzed with pulsedfield gel electrophoresis (PFGE). ResultsA total of 22 CRAB strains were isolated in OctoberDecember 2015, 19 (86.36%) of which were isolated from sputum. The resistance rate of 22 CRAB strains to compound sulfamethoxazole was 59.09%, resistance rate to minocycline was 9.09%, all were sensitive to polymyxin B, resistance rates to other antimicrobial agents were more than 80%. Three kinds of resistance genes KPC2, IMP and NDM1 were not found by PCR amplification, positive rates of VIM and OXA23 were both 100%. PFGE homology analysis revealed that 22 strains were divided into 13 different types, each type contained 15 strains, 9 types(69.23%) contained only 1 strain respectively, the other 4 types (30.77%) contained 25 strains. A5, A7, and A8; A9, A11, A14, A19 and A22; A4, A10 and A12; A16 and A18 were of the same type respectively. ConclusionThe main types of βlactamaseresistant genes of CRAB in RICU are VIM and OXA23. Homology analysis shows a small parts are of the same clone strains, which reveals epidemic of a small scale.

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李天娇, 黄涛, 吴华,等.呼吸ICU耐碳青霉烯类鲍曼不动杆菌耐药基因的携带情况及同源性[J]. 中国感染控制杂志,2018,17(1):16-20. DOI:10.3969/j. issn.1671-9638.2018.01.004.
LI Tianjiao, HUANG Tao, WU Hua, et al. Carriage of drug resistance genes and homology of carbapenemresistant Acinetobacter baumannii isolated from respiratory intensive care unit[J]. Chin J Infect Control, 2018,17(1):16-20. DOI:10.3969/j. issn.1671-9638.2018.01.004.

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  • 收稿日期:2017-02-22
  • 最后修改日期:2017-05-12
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  • 在线发布日期: 2017-12-29
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