摘要
目的了解呼和浩特地区2010年临床分离鲍曼不动杆菌的耐药表型和多种耐药基因的携带情况。方法收集2所三级甲等医院临床分离的非重复鲍曼不动杆菌113株,采用纸片扩散法进行药敏试验,试验结果按照CLSI 2010年版标准判读,采用WHONET5.6软件进行数据分析;应用聚合酶链反应(PCR)和测序方法检测10种耐药相关基因(blaOXA-51-like、blaOXA-23-like、blaOXA-24-like、blaOXA-58-like、blaTEM、blaampC、armA、ISAba1、intI1和intI2),依据耐药基因的检出情况,分析并命名相应的耐药基因谱(RGP)。结果鲍曼不动杆菌对米诺环素的耐药率最低,为15.9%;对碳青霉烯类抗生素亚胺培南和美罗培南的耐药率分别为40.7%和46.0%;对其他抗菌药物的耐药率为51.3%～91.2%;耐药相关基因blaOXA-51-like、blaOXA-23-like、blaTEM、blaampC、armA、ISAba1和intI 1的阳性率分别为100%、55.8%、86.7%、61.1%、92.0%、93.8%和90.3%,未检出blaOXA-24-like、blaOXA-58-like和intI2;共发现存在18种RGP,其中RGP1、RGP2和RGP3所占的比率均大于20%,为主要的流行的RGP。结论碳青霉烯类抗生素和米诺环素对鲍曼不动杆菌仍具有较好的体外抗菌活性,鲍曼不动杆菌多重耐药相关基因的携带率较高,多重耐药现象非常严重,应加强其耐药性监测,合理使用抗菌药物。
Objective Present study was designed to gain an insight into the antibiotic resistance phenotypes and the prevalent resistance genes profile in Acinetobacter baumannii strains isolated from 2 hospitals in Huhhot. Methods One hundred and thirteen A. baumannii isolates were collected during 2010. All isolates were analyzed with WHONET 5.6 software for the susceptibility to 17 antimicrobial agents according to CLSI 2010 breakpoints. PCR was conducted to detect resistant genes of blaOXA-51-like , blaOX-23-like , blaOX-58-like , blaTEM , blaampC , armA, ISAba1 and intI 1 and intI 2. The resistance genes profile （RGP） of all the tested isolates was designated according to the combinations of these genes. Results For most of the antibiotics tested, about 51.3% to 91.2% of these A. baumannii isolates were resistant. These strains were the least resistant to minocycline （15.9%）, followed by imipenem （40. 7%） and meropenem （46. 0 %）. Resistant genes blaOX-51-like （ 100% ）, blaOX-23-lik3 （55.8%）, blaampc （61. 1%）, armA （92. 0%）, ISAba1 （93.8%）, blaTEM（86. 7%） and intI 1 （90.3%） genes were highly prevalent in the A. baumannii isolates. Genes blaOX-24-like, blaOX-58-like and intI 2 were not identified. Of the 18 identified RGPs, RGP1, RGP2, and RGP3 were wide spread in Huhhot, each accounting for 20% or more of all the strains. Conclusions Carbapenems and minocycline still show good in vitro activity against A. baumannii. Multidrug-resistant genes are highly prevalent in A. baumannii isolates. Multi-drug resistant A. baumannii infection is a serious issue which should be managed by active surveillance of antimicrobial resistance and rational use of antimicrobial agents.
出处
《中国感染与化疗杂志》
CAS
北大核心
2013年第3期214-217,共4页
Chinese Journal of Infection and Chemotherapy
基金
内蒙古自治区自然科学基金项目(2010MS1129)
关键词
鲍曼不动杆菌
耐药监测
耐药基因
Acinetobcter baumannii
drug resistance
resistant gene
