摘要
目的明确医院临床分离老年患者耐亚胺培南鲍氏不动杆菌的耐药性、同源性、碳青酶烯酶基因型及其基因周围环境。方法收集医院2005年1月-2007年1月临床分离的142株鲍氏不动杆菌,纸片扩散法筛选耐亚胺培南鲍氏不动杆菌;琼脂稀释法测定亚胺培南耐药菌株对14种抗菌药物的MIC值;脉冲场凝胶电泳(PFGE)分析亚胺培南耐药菌株同源性;PCR扩增及克隆测序分析碳青酶烯酶基因及其周围基因环境。结果142株鲍氏不动杆菌中筛选到97株耐亚胺培南鲍氏不动杆菌;PFGE分型中全部菌株属于4个流行的克隆株;97株耐亚胺培南鲍氏不动杆菌中90株携带OXA-23-like基因,97株携带OXA-51-like基因,86株菌株OXA-23-like基因上游检测到插入序列ISAba1,6株OXA-51基因上游检测到ISAba1。结论所有耐亚胺培南鲍氏不动杆菌均为泛耐药菌,克隆播散是最主要的传播方式,OXA-23组和OXA-51组D类β-内酰胺酶基因是最主要的碳青酶烯酶基因型,未检测到OXA-24组、OXA-58组I、MP型和VIM型碳青酶烯酶基因,OXA类碳青酶烯酶基因与插入序列ISAba1关系密切。
OBJECTIVE To identify the antibiotic resistance, homology and the carbapenemases determinants of imipenem-resistant strains of Acinetobacter baumannii isolated from elderly in the Zhejiang Hospital. METHODS All 142 strains of A. baumannii were isolated from Zhejiang Hospital through Jan 2005 to Jan 2007. K-B method was used to screen imipenem-resistant strains. The MICs of imipenem-resistant strains to 14 antimicrobial agents were determined by agar dilution method. The homology of these isolates was analyzed by pulse-field gel electrophoresis （PFGE）. The coding genes of carbapenamases and the gene environments were investigated by PCR, clone, and sequencing. RESULTS Ninety-seven strains of imipenem-resistant A. baumannii were isolated from 142 strains. All of the strains of carbapenem resistant A. baumannii belonged to 4 epidemic PFGE-clones. Ninety carbapenem resistant strains contained OXA-23-1ike carbapenemase gene and 91 isolates were positive for OXA-51-1ike gene. OXA-23-1ike gene of 86 strains was just on the down-stream of insert sequence ISAbal. OXA-51-like gene of 6 strains had an ISAbal sequence just on the up-stream. CONCLUSIONS All imipenem-resistant strains of A. baurnannii are pan-resistant isolates. Clone dissemination is the most important style of strains spread. No OXA-24-like, OXA-58-1ike, IMP-like, and VIM-like gene are detected. OXA-23-like and OXA-51-like gene are the most popular carbapenemases coding genes of these strains in the Zhejiang Hospital. ISAhal has close relationship with OXA type carbapenemases genes in Zhejiang Hospital.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第10期1171-1174,共4页
Chinese Journal of Nosocomiology
关键词
鲍氏不动杆菌
耐药性
脉冲场凝胶电泳
碳青酶烯酶
插入序列
Acinetobacter baumannii
Resistance
Pulsed-field gel electrophoresis （PFGE）
Carbapenemase
OXA
ISAbal
