摘要
目的研究杭州市区4所医院鲍氏不动杆菌耐药性及主要β-内酰胺酶分布,为临床治疗鲍氏不动杆菌感染提供依据。方法采用全自动微生物分析系统VITEK-AMS 60对36株耐亚胺培南鲍氏不动杆菌进行鉴定;用琼脂稀释法和E-test法测定14种抗菌药物最低抑菌浓度(MIC),脉冲场凝胶电泳(PFGE)分析亚胺培南耐药株的同源性;采用PCR对36株耐亚胺培南β-内酰胺酶基因进行扩增,并通过序列分析明确基因型。结果36株耐亚胺培南鲍氏不动杆菌均产OXA-23型碳青酶烯酶;其中5株同时产PER-1型酶,2株同时产TEM-1型酶;2-巯基丙酸抑制试验未检测到金属酶;多次质粒提取均未成功;脉冲场凝胶电泳发现4所医院均存在耐药株的克隆传播,大多感染者为重症监护病房(ICU)患者。结论杭州市区4所医院均有耐亚胺培南鲍氏不动杆菌克隆传播,36株耐亚胺培南均产OXA-23型碳青酶烯酶,5株菌株同时产PER-1型超广谱β-内酰胺酶,2株同时产TEM-1型酶。
OBJECTIVE To investigate the resistance and the distribution of the main β-1actamases encoding gene in Acinetobacter baurnannii isolated from four hospitals in Hangzhou city to provide the basic data for the optional treatment of A. baumannii infection. METHODS The identification of A. baumannii was performed using VITEK-AMS60. The minimum inhibitory concentrations （MIC） was examined by agar dilution and E-test. The homology of the resistant isolates was finished by pulsed field gel electrophoresis （PFGE）. PCR and sequencing were used to analyze the β-lactamases encoding gene of the 36 strains of imipenem-resistant A. baumannii. RESULTS All of the imipenem-resistant isolates produced carbapenemase OXA-23, and 5 isolates produced PER- 1,2 isolates produced TEM-1 except OXA-23. No metallo-β-lactamases were detected. No plasmid was extracted. Clone transmission of the imipenem-resistant strains existed in the 4 hospitals. Most strains were isolated from intensive care unit （ICU）. CONCLUSIONS The clone transmission of imipenem-resistant A. baumannii strains is occurred in 4 hospitals. All strains produce carbapenemase OXA-23. Five strains also produce PER-1 type extended-spectrum β-lactamases. Two strains also produce TEM-1 type extended-spectrum β-lactamases.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2007年第3期250-253,共4页
Chinese Journal of Nosocomiology
基金
杭州市卫生局基金资助项目(2003A007)
关键词
鲍氏不动杆菌
耐药基因
同源性
Acinetobacter baumannii
Drug resistance gene
Homology
