多药耐药鲍曼不动杆菌耐药基因与其耐药表型关系的分析

摘要

Objective OBJECTIVE To investigate the drug-resistant mechanism of Multi-drug Acinetobacter Bau-mannii (MDRAB),thus providing a theoretical basis for the effective treatment of MDRAB in clinical.Methods Drug-resistant gene sequencings for 94 MDRAB were made by Polymerase Chain Reaction (PCR).Drug resistances were contrasted between positive group and the negative group of 8 drug resistance genes of MDRAB.Results The detection rates of 8 drug resistance genes were VIM 35.1%,SIM 55.0%,TEM 59.6%,OXA-23 93.6%,OXA-24 52.1%,SHV 52.1%,PER-1 83.0%,IMP 2.1%.Drug resistance of Imipenem (IPM),meropenem (MEM),Ampicillin/Sulbactam (SAM)were only found to be significantly different between the positive group and negative group of OXA-23 gene. And drug resistance of SAM was only found to be significantly different between the positive group and negative group of SIM gene.Conclusion This study revealed that drug-resistant gene sequencing of MDRAB could not replace the nor-mal drug susceptibility testing,for its unpredictable clinical therapeutic effect.Besides,Minocycline (MH)and Poly-myxin B (PO)were still the better treatment in MDRAB.%目的：研究多药耐药鲍曼不动杆菌（MDRAB）的耐药机制，为临床有效治疗该菌感染提供依据。方法应用 PCR 技术对94株 MDRAB 进行耐药基因检测，比较8种耐药基因阳性组与阴性组菌株的耐药性。结果耐药基因检出率：VIM 35．1％、SIM 55．0％、TEM 59．6％、OXA-2393．6％、OXA-2452．1％、SHV 52．1％、PER-183．0％、IMP 2．1％；仅 IPM、MEM、SAM 在 OXA-23基因阳性组与阴性组间，和 SAM 在 SIM 基因阳性组与阴性组间的耐药性有显著差异。结论 MDRAB 耐药基因检测不能代替常规药敏试验，无法预测临床治疗效果；MH、PO 仍为治疗MDRAB 的较好选择。