摘要
目的了解广泛耐药鲍曼不动杆菌(XDRAb)β-内酰胺酶耐药基因分布情况,为临床防治工作提供依据。方法选取泸州市中医医院临床送检标本中分离的102株鲍曼不动杆菌(Ab),检测其耐药情况。提取Ab基因组DNA进行PCR扩增,产物经琼脂糖凝胶电泳,分析β-内酰胺酶耐药基因型分布情况。结果分离的102株Ab为XDRAb菌株,其对亚胺培南、头孢哌酮/舒巴坦的耐药率分别为74.51%和70.59%;对氨苄西林、呋喃妥因、头孢唑啉和头孢替坦为全耐药;对替加环素耐药率较低,为7.84%;多黏菌素E的抑菌环直径97.06%在11~17 mm,耐药率低。OXA基因中,OXA-20、23、24、51阳性率分别为4.90%、58.82%、24.51%、76.47%,插入序列ISA-OXA-23和ISA-OXA-51阳性率分别为63.73%和21.57%。ESBLs基因中,TEM阳性率较高,为76.47%,SHV阳性率低,为9.80%。AmpC基因中,ADC阳性率较高,为85.29%,DHA阳性率较低,为23.53%。MBLs基因中,IMP-4和VIM阳性率分别为18.63%和20.59%,CTX-M1阳性率为11.76%,PER和GES阳性率低,均为6.86%,Ⅰ类整合基因INT-1阳性率为11.76%。结论XDRAb的β-内酰胺酶耐药基因分布较广泛,存在耐药基因TEM、OXA-23、OXA-51、ADC等是其耐药的主要原因。
Objective To understand the distribution ofβ-lactamase resistance gene of extensively drug-resistant Acinetobacter baumannii(XDRAb),and to provide the basis for clinical prevention and treatment.Methods A total of 102 strains of Acinetobacter baumannii(Ab)isolated from clinical samples submitted by Luzhou Traditional Chinese Medicine Hospital were selected to detect their drug resistance.The Ab genomic DNA was extracted for PCR amplification,and the product was subjected to agarose gel electrophoresis.The distribution ofβ-lactamase resistance genotype was analyzed.Results The 102 Ab isolated were XDRAb,and the resistance rates to imipenem and cefoperazone/sulbactam were 74.51%and 70.59%respectively.Ampicillin,furantoin,cefazolin and cefotetan were all resistant.The drug resistance rate of tigacycline was low,which was 7.84%.The inhibition ring diameter of polymyxin E was 97.06%in the range of 11-17 mm,and the drug resistance rate was low.Among the OXA genes,the positive rates of OXA-20,23,24 and 51 were 4.90%,58.82%,24.51%and 76.47%respectively.The positive rates of the insertion sequences ISA-OXA-23 and ISA-OXA-51 were 63.73%and 21.57%respectively.In ESBLs gene,the positive rate of TEM was higher(76.47%),and the positive rate of SHV was lower(9.80%).Among AmpC gene,the positive rate of ADC was higher(85.29%),and the positive rate of DHA was lower(23.53%).Among the MBLs gene,the positive rates of IMP-4 and VIM were 18.63%and 20.59%respectively,CTX-M1 was 11.76%,PER and GES were 6.86%,and the positive rate of INT-1 of theⅠclass of integrators was 11.76%.Conclusion XDRAbβ-lactamase resistance genes are widely distributed,and TEM,OXA-23,OXA-51,ADC and other resistant genes are the main reasons for its drug resistance.
作者
郑琳
张帮林
李萌
顾成武
ZHENG Lin;ZHANG Banglin;LI Meng;GU Chengwu(Department of Clinical Laboratory,Luzhou Traditional Chinese Medicine Hospital,Luzhou,Sichuan 646000,China;Department of Neurology,Suining Central Hospital,Suining,Sichuan 629000,China)
出处
《国际检验医学杂志》
CAS
2021年第12期1499-1502,共4页
International Journal of Laboratory Medicine
关键词
广泛耐药鲍曼不动杆菌
Β-内酰胺酶
耐药基因
extensive drug-resistance Acinetobacter baumannii
β-lactamase
resistance genes
