210株不动杆菌中碳青霉烯酶基因的检测.docVIP

精品论文 参考文献 210株不动杆菌中碳青霉烯酶基因的检测 李静 黄凯月 刘志敏 卿文衡 　　（湖南省衡阳市中心医院检验科 421001） 　　【摘要】目的 检测碳青霉烯酶基因在本医院210株内科患者标本中分离出来的不动杆菌属中的分布情况，以指导临床合理应用抗生素。方法 采用WHONET软件统计分析药敏结果，利用PCR扩增和琼脂糖凝胶电泳法检测OXA23、OXA24、OXA51、OXA58碳青霉烯酶基因。结果 210株不动杆菌耐碳青霉烯的有63株，不动杆菌耐美洛培南和亚胺培南的耐药率分别为32.9%和30.6%，且比较两种耐碳青霉烯类抗生素，差异无统计学意义（Pgt;0.05）；耐药菌株中30株OXA-23基因阳性，9株OXA-58基因阳性，60株OXA51基因阳性，仅1株OXA-24基因阳性。结论 不动杆菌多重耐药性严重，基因型检测证实本院临床分离不动杆菌对碳青霉烯类耐药机制主要是产OXA23型和OXA51型。 　　【关键词】不动杆菌 碳青霉烯酶基因 耐药性 　　【中图分类号】R446.5 【文献标识码】A 【文章编号】1672-5085（2014）05-0057-02 　　 　　【Abstract】 Objective To detect the distribution of carbapenemase gene of Acinetobacter from 210 strains medical case of patients samples in our Hospital and guide the rational clinically use of antibiotics. Methods All date were analyzed based on WHONET software, Analysis of PCR and agarose gel electrophoresis were used to detect carbapenemase genes including OXA-23,OXA-24,OXA-51,OXA-58. Results There are 210 strains of Acinetobacter 63 of them had resistant to carbapenem.; The resistance rates of Acinetobacter to meropenem and imipenem were 32.9% and 30.6%, and the comparison of two carbapenem antibiotic resistance, the difference was not statistically significant (Pgt;0.05); 60 strains carried OXA-51 gene, 30 strains carried OXA-23 gene, 9 strains carried OXA-58 gene and only one strains carried OXA-24 gene. Conclusion The phenomenon of the Acinetobacter is multidrug resistanct was serious. The genotype test confirmed the main genotypes carbapenemase-wesisent were two types of OXA-23 and OXA-51.Which were closely assotiated with the carbapenemase-wesisent development in Acinetobacter. 　　【Key words】Acinetobacter Carbapenemase gene Drug resistance 　　不动杆菌是非发酵的革兰阴性球杆菌，为专性需氧菌。广泛分布于住院病人和医院环境中,是引起医源性感染的重要条件致病菌[1]。本研究通过PCR扩增和琼脂糖凝胶电泳，检测了我院内科患者标本中不动杆菌对碳青霉烯酶基因的耐药性情况，并进行耐药性和碳青霉烯酶基因的分析。从而对耐药基因予以监测并及时反馈于临床，及时采取流行病学防治措施。防止院感形成以及为临床合理使用抗菌药物提供依据。 　　1 材料和方法 　　1.1 菌株来源 收集来自本院检验科提供的患者标本中分离的210株不动杆菌；阳性对照菌株由本实验室提供。 　　1.2 主要试剂 dN