耐亚胺培南鲍曼不动杆菌耐药机制探究.doc

耐亚胺培南鲍曼不动杆菌耐药机制探究 　 作者：方平 潘晓龙 周东升 吴祥林 毕业论文 【摘要】; 目的 研究鲍曼不动杆菌对亚胺培南的耐药机制。方法 对临床分离的3株耐亚胺培南的鲍曼不动杆菌，采用KB纸片扩散法(CLSI/NCCLS 2004年标准)进行药敏试验，三维试验检测ESBLs和AmpC酶，PCR方法检测TEM、SHV、PER、VEB、AmpC、IMP、VIM、OXA?23和OXA?24等9种耐药基因型，PCR阳性产物进行基因测序，结果在GenBank基因库中比对分析。结果 3株鲍曼不动杆菌为多重耐药菌株，三维试验均产生ESBLs，1株产生AmpC酶，耐药基因型检测3株TEM阳性，2株PER阳性，2株AmpC酶阳性及SHV、VEB和IMP、VIM、OXA?24型等均为阴性；3株OXA?23型均阳性；另外27株对亚胺培南敏感鲍曼不动杆菌IMP、VIM、OXA?23和OXA?24型检测结果均阴性。结论 耐亚胺培南鲍曼不动杆菌携带TEM、PER、非诱导AmpC酶、OXA?23型碳青霉烯酶基因，产生OXA?23型碳青霉烯酶是主要耐药机制。 毕业论文 【关键词】; 鲍曼不动杆菌 OXA?23型碳青霉烯酶 耐药基因型 毕业论文 ; Mechanism of imipenem?resistance in Acinetobacter baumannii 毕业论文 ABSTRACT; Objective; To study the mechanism of imipenem?resistance in Acinetobacter baumannii. Methods; Antimicrobial susceptibility test was done on 3 strains of Acinetobacter baumannii isolated in Tongling by Kirby?Bauer method. Results were assessed according to the standands recommended by; CLSI/NCCLS (2004). The detection of ESBLs and AmpC β?lactamases was performed by three?dimensional test, the genotype of TEM, SHV, PER, VEB, AmpC, IMP, VIM, OXA?23, OXA?24, and the detection and sequence analysis was performed by polymerase chain reaction (PCR).; Results; Three strains in Acinetobacter baumannii were multi?drug resistant. Three strains of imipenem?resistance were positive for blaTEM gene, 2 strains had blaPER gene, and 2 had ampC gene, OXA?23 type gene were detected in these three isolates, but no SHV, VEB, IMP, VIM and OXA?24 type gene was detected. Twenty?seven strains of imipenem?susceptibility in Acinetobacter baumannii were negative for IMP, VIM, OXA?23 and OXA?24.; Conclusions; Acinetobacter baumannii carried TEM, PER, AmpC and OXA?23 type gene, production of OXA?23 carbapenemase in Acinetobacter baumannii was one of the main mechanisms of imipenem resistance the Tongling People′s hospital. 毕业论文 ; KEY WORDS; Acinetobacter baumannii OXA?23 carbapenemase Resistant genetype 毕业论文 鲍曼不动杆菌是院内感染的重要病原菌之一。随着广谱抗菌药物的大量使用，抗生素选择性压力不断增加，鲍曼不动杆菌的分离率呈逐年上升趋势，对抗菌药物的耐药性日益严重