多利培南对76株鲍曼不动杆菌OXA-23基因组介导的耐药性分析.DOCVIP

多利培南对18株产OXA-58型碳青霉烯酶鲍曼不动杆菌的抗菌活性研究 田雪，唐昊，靳钰，修清玉( 【摘要】 目的 了解我院临床分离鲍曼不动杆菌中鲍曼不动杆菌(Acinetobacter baumannii,Ab) 碳青霉烯酶OXA-58基因存在状况，及多利培南对其抗菌活性。方法 收集我院分离的72株鲍曼不动杆菌，通过PCR扩增，克隆测序等方法对鲍曼不动杆菌碳青霉烯酶OXA-58基因的检测及测序分析，区分出OXA-58阳性组及OXA-58阴性组。通过微量稀释法检测碳青霉烯类抗生素多利培南、亚胺培南、美罗培南对鲍曼不动杆菌的最低抑菌浓度（Minimum Inhibitory Concentration, MIC），并分别对多利培南、亚胺培南、美罗培南对OXA-58阳性组的MIC，多利培南对OXA-58阳性组及OXA-58阴性组鲍曼不动杆菌的MIC进行统计学分析。结果 72株鲍曼不动杆菌中，碳青霉烯酶OXA-58基因阳性组为18株，阳性率为25%。分离的Ab菌中，碳青霉烯酶OXA-58基因携带率较高。多利培南对Ab菌的MIC50、MIC90均明显低于亚胺培南及美罗培南。对OXA-58阳性组鲍曼不动杆菌的最低抑菌浓度，多利培南组与亚胺培南组、美罗培南组比较差异有显著统计学意义（t值分别为5.657、6.216，p＜0.01）。多利培南对OXA-58阳性组的MIC50、MIC90均低于OXA-58阴性组的MIC50、MIC90。多利培南对OXA-58阳性组的MIC，与OXA-58阴性组比较差异有显著统计学意义（t值为7.493，p＜0.01）。结论 OXA-58编码的碳青霉烯酶是鲍曼不动杆菌耐药的原因。多利培南对OXA-58碳青霉烯酶的Ab菌，低于不OXA-58基因的鲍曼不动杆菌。相比，对携带OXA58基因的Ab菌，多利培南具有更低的MIC。tudies on antibacterial activity study of Doripenem to 18 Acinetobacter baumannii producing OXA-58 carbapenemase TIAN Xue, TANG Hao, JIN Yu, XIU Qing-yu. Department of Respiratory Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China Corresponding Author: XIU Qing-yu, Email: xiu_qingyu@126.com 【Abstract】Objective This study detect carbapenemase OXA-58 gene Acinetobacter baumannii(Ab) in clinical isolating Acinetobacter baumannii of our hospital, and observe antibacterial activity of doripenem. Methods We collect 72 clinical isolating Acinetobacter baumannii in our hospital, detecting and sequencing Acinetobacter baumannii carbapenemase OXA-58 gene through PCR amplification and cloning. Then we divide into OXA-58 gene positive group and OXA-58 negative group.We detect Minimum Inhibitory Concentration(MIC) of doripenem, imipenemm and meropenem to Acinetobacter baumannii through microdilution method.Then we carry statistical analysis in MIC of doripenem, imipenemm and meropenem to OXA-58 gene positive group, and MIC of doripenem to OXA-58 positive group and OXA-58 negative group. Results In 72 clinical isolating Acinetobacter baumannii, a total of 18Acinetob