多重耐药鲍曼不动杆菌β-内酰胺类耐药基因研究

摘要

目的：了解β-内酰胺类耐药基因在某院临床分离的多重耐药鲍曼不动杆菌（MDRAB）中的流行情况。方法对该院临床分离的22株 MDRAB 进行药敏试验，同时，采用聚合酶链反应（PCR）技术对其进行β-内酰胺类耐药基因（TEM、SHV、CTX-M、PER、DHA、IMP 、VIM 、SIM、OXA-23、OXA-24、OXA-58）检测。结果22株MDRAB 对头孢他啶、头孢噻肟、头孢吡肟、庆大霉素、阿米卡星、环丙沙星和复方磺胺甲口恶唑耐药率均为100．00％；对亚胺培南、美罗培南、头孢哌酮／舒巴坦的耐药率分别为50．00％、40．91％、31．82％，中介率分别为31．82％、36．36％、31．82％。22株（100．00％）MDRAB 均携带耐药基因 OXA-23群，16株（72．73％）携带 TEM，12株（54．55％）携带 IMP ，4株（18．18％）携带 PER；SHV、CTX-M、DHA、VIM 、SIM、OXA-24群、OXA-58群基因检测均为阴性。结论携带 IMP 、TEM、PER、OXA-23耐药基因是导致该院 MDRAB 对β-内酰胺酶类抗生素耐药的重要机制。%Objective To investigate prevalence of resistance genes for β-lactams in clinically isolated multidrug-resistant Acinetobacter baumannii (MDRAB)in a hospital.Methods 22 clinically isolated MDRAB strains were performed antimicrobial susceptibility testing,resistance genes forβ-lactams (TEM,SHV,CTX-M,PER,DHA, IMP ,VIM ,SIM,OXA-23,OXA-24,and OXA-58)in these strains were detected with polymerase chain reaction. Results The resistant rates of 22 isolates of MDRAB to ceftazidime,cefotaxime,cefepime,gentamycin,amikacin, ciprofloxacin,and compound sulfamethoxazole were all 100.00%;to imipenem,meropenem,and cefoperazone/sul-bactam were 50.00%,40.91 %,and 31 .82% respectively,intermediated rates were 31 .82%,36.36%,and 31 .82% respectively.The carriage rates of OXA-23,TEM,IMP ,and PER were 100.00% (n =22),72.73 %(n=16),54.55% (n = 12),and 18.18% (n =4)respectively.Detection results of SHV,CTX-M,DHA,VIM , SIM,OXA-24,and OXA-58 were all negative.Conclusion Carriage of IMP ,TEM,PER,and OXA-23 resistance genes are the major resistance mechanisms of MDRAB to β-lactamase antimicrobial agents in this hospital.