摘要
目的碳青霉烯耐药鲍曼不动杆菌(CRAB)逐年升高的分离率和全球播散已成为极为严重的问题,本研究目的是阐明我院CRAB的耐药机制和分子流行病学特征。方法使用gyrB多重PCR方法将我院2014年7月—2015年6月分离的327株非重复醋酸钙-鲍曼不动杆菌复合体(ABC)鉴定到种,VITEK-2仪器法和E-test法测定抗菌药物的最低抑菌浓度(minimal inhibitory concentration MIC),PCR方法检测常见的碳青霉烯酶耐药基因、ISAba1并测序,Turton 2组多重PCR方法进行分子分型。结果327株ABC中有315株鲍曼不动杆菌(ABA)、9株皮特不动杆菌和3株医院不动杆菌,ABA、皮特和医院不动杆菌对亚胺培南的耐药率分别为91.7%、0和66.7%,耐药株主要分离自急诊科和呼吸ICU。ABA bla_(OXA-23-like)和ISAba1检出率均为91.1%,测序均为bla_(OXA-23),bla_(OXA-51-like)和ISAba1检出率分别为100%和0.3%,测序主要为bla_(OXA-66)和bla_(OXA-69),未检测到其他OXAs型、NDM、IMP、GIM、KPC、SIM、VIM和GES酶基因。Turton分子分型76.8%属于国际克隆Ⅱ型(IC Ⅱ)。结论携带bla_(OXA-23)和ISAba1的IC Ⅱ克隆是我院主要的流行克隆株,克隆播散是CRAB感染增加和暴发的重要原因。
Objective The increasing prevalence and global spread of earbapenem-resistant Acinetobacter baumannii （CRAB） has become a serious problem. This study was to investigate the resistant mechonism and molecular epidemiological characteristics of CRAB isolates collected from our hospital. Methods 327 non- duplicated Acinetobacter calcoaceticus-Acinetobacter baumannii complex （ABC） isolates collected between 2014.7 and 2015.6 were identified using gyrB multiplex PCR. Antimicrobial susceptibility tests were performed using the minimal inhibitory concentrations （MIC） of E-test and VITEK-2. PCR and sequencing were performed to detect the common genes encoding carbapenemase and insertion sequence of ISAbal. Isolates were typed by Turton two groups multiplex PCR. Results A total of 315 A. baumannii （ABA）, 9 A. pittti, and 3 A. nosocomialis were identified. The resistance rates ofABA, A. pittii andA. nosocomialis to impenem were 91.7%, 0, and 66.7%, respectively. Resistant isolates were collected mainly from the department of emergency and respiratory ICU. Among A. baumannii, 91.1% wore positive for blaOXA-23-like and ISAbal, which were confirmed to be blaOXA-2e; 100% and 0.3% were positive for blaOXA-51-like and ISAbal, which were confirmed to be blaOXA-66 or blaOXA-69. The isolates were negative for other OXAs, NDM, IMP, GIM, KPC, SIM, VIM, and GES carbapenemase genes. Of 315 A. baumannii isolates, 76.8% belonged to international clones Ⅱ （IC Ⅱ）. Conclusion IC Ⅱclone containing blaOXA-23 with ISAbal upstream of the gene is the predominant clone. These results suggested that the clone spread played an important role in the outbreak of CRABs in our hospital.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2017年第8期704-710,共7页
Chinese Journal of Antibiotics
基金
国家留学基金委青年骨干教师出国培训项目(No.201306015022)
