摘要
目的了解本院多重耐药鲍曼不动杆菌(MDRAB)分子流行病学特征和氨基糖苷类耐药机制,为临床合理用药及控制院内感染提供依据。方法用纸片扩散法和琼脂稀释法检测泛耐药株对抗菌药物的敏感性,特异性PCR检测氨基糖苷类耐药基因、intI 1、intI 2基因及可变区。基因外重复回文序列(REP)-PCR分析菌株同源性。结果 67株MDRAB对多种抗菌药物广泛耐药,对阿米卡星100%耐药。PCR检测结果显示64株分离菌株携带Ⅰ类整合酶基因,其中61株可变区扩增阳性,分别为携带aacA4-catB-aadA1(2 300 bp)基因盒44株和携带aacC1-orfX-orfX-orfX'-aadA1基因盒(3 000 bp)17株;59株携带armA甲基化酶基因。REP-PCR分析显示耐药菌株属于6个克隆型,主要为A1～A3和B2型。结论甲基化酶介导本院鲍曼不动杆菌临床分离株对氨基糖苷类药物耐药。本院存在以A型和B型克隆株为主的感染流行,必须加强院内感染防控,切断克隆菌株的传播。
Objective To investigate the characteristics of molecular epidemiology and the aminoglycoside-resistant mechanism of multidrug-resistant Acinetobacter baumammji （MDRAB） isolates in our hospital, and provide the evidences for clinical rational medication and control of nosocomial infection. Methods Antibiotic susceptibility of MDRAB was detected by K-B agar diffusion and agar dilution methods. The detection of aminoglycoside-resistant genes, intI 1, intI 2 and variable region of integron were performed with specific PCR and DNA sequencing. The homology of isolates was analyzed by repetitive extragenic palindromic （ REP）-PCR. Results Sixty-seven MDRAB isolates were resistant to most of the antibiotics, and all the isolates were resistant to amikacin. The results of specific PCR and DNA sequencing showed 64 isolates carried with integrase gene intI 1, of which 61 were positive for the variable region of integron, including 44 carried with aacA4-catB-aadA1 box gene （2 300 bp） and 17 with aacCl-orfX-orfX-orfX＇-aadAl box （3 000 bp）. In addition, 59 isolates carried armA methylase gene. REP-PCR revealed that the 67 drug-resistant isolates were divided into six genetypes, and A1, A2, A3 and B2 were the predominant. Conclusion ArmA methylase may participate in the aminoglycoside-resistant mechanism of MDRAB. In our hospital, the main genetypes of MDRAB were A and B, which indicated that the control of nosocomial infection should be enhanced, and the propagation of clone strains must be blocked.
出处
《临床检验杂志》
CAS
CSCD
北大核心
2012年第8期577-579,共3页
Chinese Journal of Clinical Laboratory Science
基金
南京市卫生局课题(YKK10061)
关键词
鲍曼不动杆菌
多重耐药
整合子
氨基糖苷类
耐药机制
Acinetobacter baumannii
multidrug-resistant
integron
aminoglycoside
resistant mechanism
