36株多重耐药鲍曼不动杆菌对氨基糖苷类药物耐药基因的流行病学研究

摘要

目的：了解多重耐药鲍曼不动杆菌中氨基糖苷类耐药基因的存在情况。方法收集2012年8-11月江苏大学附属医院和镇江市第一人民医院住院患者的临床标本中分离到的多重耐药鲍曼不动杆菌菌株36株。应用 K-B 纸片扩散法检测多重耐药鲍曼不动杆菌对抗菌药物的敏感性、应用 PCR 检测细菌对氨基糖苷类药物的耐药基因。结果36株多重耐药鲍曼不动杆菌对头孢哌酮-舒巴坦有较高的敏感率（33．3％），对其他抗菌药物的敏感率均较低（＜20．0％）。36株多重耐药鲍曼不动杆菌中氨基糖苷类耐药基因 aac （3）-I、aac （6’）-Ib、aph（3’）-I 和16S rRNA 甲基化酶基因 armA 的阳性率分别为72．2％（26株）、72．2％（26株）、80．6％（29株）和80．6％（29株）。结论本组多重耐药鲍曼不动杆菌多耐药情况比较严重，其对氨基糖苷类药物耐药与氨基糖苷类耐药基因的存在密切相关。%Objective To investigate the prevalence of genes conferring aminoglycoside resistance in multidrug-resistant strains of Acinetobacter baumannii (MDR-ABA).Methods Multidrug-resistant A.baumannii strains were isolated during the period from August to November 2012 from patients in the affiliated hospital of Jiangsu University and the First Hospital of Zhen-jiang.Kirby-Bauer diffusion method was used to determine the susceptibility of these strains to antimicrobial agents.PCR was performed to detect the aminoglycoside resistance genes.Results The 36 MDR-ABA strains showed high resistance rates to most antimicrobial agents except cefoperazone-sulbactam.The prevalence of the genes conferring aminoglycoside resistance, aac (3)-I,aac (6’)-Ib,aph (3’)-I and armA,was 72.2% (26/36),72.2% (26/36),80.6% (29/36)and 80.6% (29/36), respectively.Conclusions The MDR-ABA strains in this study are highly resistant to antimicrobial agents,which is closely as-sociated with the genes conferring aminoglycoside resistance.