鲍曼不动杆菌碳青霉烯酶耐药基因分析及同源性的研究.docVIP

鲍曼不动杆菌碳青霉烯酶耐药基因分析及同源性的研究 　　[摘要]目的 分析鲍曼不动杆菌碳青霉烯酶耐药基因型和医院感染鲍曼不动杆菌同源性。方法 回顾性分析2013年1月～2014年8月非重复分离的68株耐碳青烯酶鲍曼不动杆菌（CRAB），多重PCR的方法检测6种常见的β-内酰胺酶基因IMP、VIM、OXA-23、OXA-24、OXA-58和OXA-51，并对其中确定为医院感染的8株用脉冲场凝胶电泳（PFGE）进行基因同源性分析。结果 68株多重耐药鲍曼不动杆菌全部检出OXA-23、OXA-51基因，其余基因均未检出；8株经PFGE同源性分析提示为同一来源克隆株，且同源性较高。结论 我院临床分离的耐碳青霉烯酶鲍曼不动杆菌主要携带OXA-23、OXA-51基因型，且存在克隆传播。 　　[关键词]鲍曼不动杆菌；碳青霉烯酶；耐药基因；同源性 　　[中图分类号] R446.1 [文献标识码] A [文章编号] 1674-4721（2017）02（c）-0115-04 　　Analysis for genotype and homology of carbapenemase resistance in Acinetobacter baumannii 　　RAO Li-hua TU Jian-bin WANG Yan-qin 　　Department of Clinical Laboratory，Nanchang Hospital of Integrated Traditional and Western Medicine in Jiangxi Province，Nanchang 330002，China 　　[Abstract]Objective To analyze the genotype and homology of drug resistance gene in carbapenemase resistant Acinetobacter baumannii（CRAB）.Methods 68 strains of CRAB isolated from January 2013 to August 2014 were included in our retrospective analysis.Multiplex Polymerase Chain Reaction（Multiplex-PCR） was conducted to analyze six types of β-lactamase resistant gene IMP，VIM，OXA-23，OXA-24，OXA-58，OXA-51 in these strains of CRAB，and the gene homology of 8 CRAB isolateswere analyzed by pulsed field gel electrophoresis（PFGE）.Results All of the 68 isolates of CRAB were found to carry OXA-23，OXA-51，but not IMP，VIM，OXA-24，OXA-58.The result of PFGE suggested that the 8 CRAB isolates might derived from the same clone.And the gene homology analysis showed high homology among them.Conclusion All the 68 CRAB strains isolated from our hospital belong to the same clone and carry OXA-23，OXA-51 genes mainly，indicating that there is clone spread among CRAB isolates. 　　[Key words]Acinetobacter baumannii；Carbapenemase；Drug resistance gene；Homology?U曼不动杆菌为不发酵糖革兰阴性杆菌，广泛存在于自然界，属于条件致病菌，是医院感染的重要病原菌之一，可引起呼吸道、泌尿道、血液、伤口等感染[1]。碳青霉烯类抗生素（亚胺培南、美罗培南等）是有效治疗革兰阴性杆菌，特别是产超广谱β-内酰胺酶（ESBLs）和持续高产C类头孢菌素酶（AmpC酶）感染的重要抗生素。近年来，广谱抗菌药物的大量运用使鲍曼不动杆菌耐药形势严峻，耐碳青霉烯类鲍曼不动杆菌（carbapenemase resistant Acinetobacter baumannii