摘要
目的研究医院肝移植术后感染乙酸钙不动杆菌产生碳青酶烯酶的基因型。方法用WHONET 5.4软件分析自肝移植患者分离的不动杆菌属的耐药性;收集对亚胺培南耐药且具有多药耐药性的乙酸钙不动杆菌8株;等电聚焦电泳测定酶的等电点;脉冲场凝胶电泳(PFGE)确定耐药株的亲缘关系;对TEM、SHV型基因及碳青酶烯酶基因OXA、IMP、VIM进行聚合酶链反应(PCR)及序列分析。结果肝移植术后感染的耐亚胺培南乙酸钙不动杆菌对多种药物耐药性高,PCR及序列分析证实8株菌均产生OXA-23型碳青酶烯酶(pI=6.7);PFGE发现器官移植病区有耐药株的克隆传播。结论医院器官移植病区存在产OXA-23型碳青酶烯酶乙酸钙不动杆菌的克隆株播散流行,加强细菌的耐药性监测,对控制感染有重要意义。
OBJECTIVE To study the carbapenemase genotypes among Acinetobacter calcoaceticus isolates infected after liver transplantation. METHODS The 5. 4 software was used to analyze the resistance of Acinetobacter species. Eight strains of imipenem-resistant A. calcoaceticus which were resistant to muhiple drugs were collected. Analytical isoelectric focusing electrophoresis was used to measure the pI of the β-lactamase. The homology of the isolates was determined by pulsed field gel electrophoresis（PFGE）, blaTEM, blaSHV, blaIMP, blaVIM, blaOXA Genes for resistant isolates were amplified and sequenced. RESULTS Imipenem-resistant A. calcoaceticus infected after liver transplantation was resistant to multiple drugs. All of 8 strains were produced OXA-23 carbapenemases （pI of 6. 7）. The results of PFGE indicated there was a trend of resistant clone transmisstion in the transplantation ward. CONCLUSIONS There is a transmisstion of A. calcoaceticus producing OXA-23 carbapenemase in the transplantation ward of our hospital. It is important to monitor powerfully the bacterial resistance to control infection more effectively.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第8期883-885,905,共4页
Chinese Journal of Nosocomiology
关键词
肝移植
不动杆菌属
碳青酶烯酶
Liver transplantation
Acinetobacter
Carbapenemase
