3株耐碳青霉烯鲍曼不动杆菌临床株耐药机制的研究.docVIP

3株耐碳青霉烯鲍曼不动杆菌临床株耐药机制的研究 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：3株耐碳青霉烯鲍曼不动杆菌临床株耐药机制的研究 1 1 材料与方法 3 2 结果 5 3 讨论 6 文2：鲍曼不动杆菌耐药机制的研究进展医学 8 1 对β-内酰胺类抗菌药物的耐药机制 8 2 对氨基糖苷类抗菌药物的耐药机制 13 3 对氟喹诺酮类抗菌药物的耐药机制 14 4 对其他抗菌药物的耐药机制 15 5 展望 16 参考文摘引言： 16 原创性声明（模板） 17 文章致谢（模板） 18 正文 3株耐碳青霉烯鲍曼不动杆菌临床株耐药机制的研究 文1：3株耐碳青霉烯鲍曼不动杆菌临床株耐药机制的研究 The mechanism of three carbapenemresistant clinical isolates of Acinetobacter baumannii ABSTRACT Objective To study the molecular mechanism of carbapenemresistant Acinetobacter baumannnii. Methods The carbapenemresistant strai were detected from clinical isolatesAcinetobacter baumannii by disk diffusion and microdiluted broth method. The blaOXA23 gene was amplified by PCR method and then sequenced. Their out membrane protei (OMP) were extracted and analyzed by using SDSpolyacrylamide gel electrophoresis and a carbapenemsusceptible Acinetobacter baumannnii strain as control. Results The PCR amplification and sequencing results showed that the three multiresiltant Acinetobacter baumannii isolates were multiresistant and all carried blaOXA23 gene. The SDSPAGE electrophoresis result showed that band deficiency was found in AB173, whereas other two resistant isolates showed the same electrophoresis profiles with the control. Conclusio In this experiment, all three carbapenemresistant Acinetobacter baumannii strai carried blaOXA23 gene and one of them lacked a OMP, which were probably attributed to the multiresistance of organisms. KEY WORDS Acinetobacter baumannii; Multiresistance; blaOXA23 gene; Outer membrane protein; Polymerase chain reaction (PCR) 在过去的几十年内，ICU病房中有创性检查及 治疗 的增加使得不动杆菌成为重要的条件致病菌，它可以导致广泛的临床并发症，例如肺炎、败血症、泌尿系感染、伤口感染、脑膜炎，尤其易发生在免疫功能低下的患者身上［1］。由于不动杆菌对氨基糖苷类、β内酰胺类等多种抗生素耐药，因此限制了治疗时对敏感药物的选择，给临床治疗带来了巨大的压力。研究显示鲍曼不动杆菌对碳青霉烯类抗生素耐药机制涉及产碳青霉烯酶、外膜蛋白(outermembrane prothin，OMP)缺失、外排泵系统表达亢进和青霉素结合蛋白突变等诸多方面。本试验收集了近期3株耐碳青霉烯鲍曼不动杆菌临床株并对其产OXA23型碳青霉烯酶和外膜蛋白的情况进行研究。 1 材料与方法 材料 (1)菌株来源和菌种鉴定 2005年从天津医科大学第二 医院 住院患者分离的