中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2009年
5期
281-287
,共7页
朱健铭%吴晋兰%姜如金%吴康乐%王建敏%孔海深
硃健銘%吳晉蘭%薑如金%吳康樂%王建敏%孔海深
주건명%오진란%강여금%오강악%왕건민%공해심
鲍氏不动杆菌%抗药性%多药%β-内酰胺酶%基因%酶活性
鮑氏不動桿菌%抗藥性%多藥%β-內酰胺酶%基因%酶活性
포씨불동간균%항약성%다약%β-내선알매%기인%매활성
Acinetobacter baumannii%Drug resistance,multiple%Beta-lactamase%Genes%Enzyme activity
目的 了解临床分离的多药耐药鲍曼不动杆菌(multi-drug resistant Acinetobacter baumannii,MDRAB)β-内酰胺酶基因存在状况以及酶活性.方法 从浙江大学医学院附属第一医院住院患者中分离62株MDRAB,采用PCR及序列分析方法分析22种β-内酰胺酶基因,同时采用酶提取物改良三维试验检测超广谱β-内酰胺酶(ESBLs)、头孢菌素酶(AmpC酶)和金属β-内酰胺酶活性.结果 62株MDRAB中,TEM、OXA-23群和ADC基因阳性株数分别为51株(82.3%)、50株(舳.6%)和36株(58.1%),其余19种基因均为阴性;任选5株TEM基因PCR阳性产物测序比对,显示与GenBank基因库中TEM-1型相同;任选6株OXA-23群基因PCR阳性产物测序比对,显示与OXA-23型碳青霉烯酶基因(登录号:CAB69042.1)相同;任选2株ADC基因测序比对,显示与ADClike型AmpC酶基因(登录号:EU081908)相同.有32株(51.6%)同时产ESBLs和AmpC酶,19株(30.6%)单独产ESBLs,1株(1.6%)单独产AmpC酶;金属β-内酰胺酶活性检测均为阴性.结论 产OXA-23群碳青霉烯酶和ADC型AmpC酶是本组MDRAB对β-内酰胺类药物耐药的主要原因.
目的 瞭解臨床分離的多藥耐藥鮑曼不動桿菌(multi-drug resistant Acinetobacter baumannii,MDRAB)β-內酰胺酶基因存在狀況以及酶活性.方法 從浙江大學醫學院附屬第一醫院住院患者中分離62株MDRAB,採用PCR及序列分析方法分析22種β-內酰胺酶基因,同時採用酶提取物改良三維試驗檢測超廣譜β-內酰胺酶(ESBLs)、頭孢菌素酶(AmpC酶)和金屬β-內酰胺酶活性.結果 62株MDRAB中,TEM、OXA-23群和ADC基因暘性株數分彆為51株(82.3%)、50株(舳.6%)和36株(58.1%),其餘19種基因均為陰性;任選5株TEM基因PCR暘性產物測序比對,顯示與GenBank基因庫中TEM-1型相同;任選6株OXA-23群基因PCR暘性產物測序比對,顯示與OXA-23型碳青黴烯酶基因(登錄號:CAB69042.1)相同;任選2株ADC基因測序比對,顯示與ADClike型AmpC酶基因(登錄號:EU081908)相同.有32株(51.6%)同時產ESBLs和AmpC酶,19株(30.6%)單獨產ESBLs,1株(1.6%)單獨產AmpC酶;金屬β-內酰胺酶活性檢測均為陰性.結論 產OXA-23群碳青黴烯酶和ADC型AmpC酶是本組MDRAB對β-內酰胺類藥物耐藥的主要原因.
목적 료해림상분리적다약내약포만불동간균(multi-drug resistant Acinetobacter baumannii,MDRAB)β-내선알매기인존재상황이급매활성.방법 종절강대학의학원부속제일의원주원환자중분리62주MDRAB,채용PCR급서렬분석방법분석22충β-내선알매기인,동시채용매제취물개량삼유시험검측초엄보β-내선알매(ESBLs)、두포균소매(AmpC매)화금속β-내선알매활성.결과 62주MDRAB중,TEM、OXA-23군화ADC기인양성주수분별위51주(82.3%)、50주(축.6%)화36주(58.1%),기여19충기인균위음성;임선5주TEM기인PCR양성산물측서비대,현시여GenBank기인고중TEM-1형상동;임선6주OXA-23군기인PCR양성산물측서비대,현시여OXA-23형탄청매희매기인(등록호:CAB69042.1)상동;임선2주ADC기인측서비대,현시여ADClike형AmpC매기인(등록호:EU081908)상동.유32주(51.6%)동시산ESBLs화AmpC매,19주(30.6%)단독산ESBLs,1주(1.6%)단독산AmpC매;금속β-내선알매활성검측균위음성.결론 산OXA-23군탄청매희매화ADC형AmpC매시본조MDRAB대β-내선알류약물내약적주요원인.
Objective To investigate the distribution of 22 beta-lactamase genes and enzyme activities in multi-drug resistant Acinetobacter baumannii (MDRAB). Methods Sixty-two MDRAB strains were isolated from the First Affiliated Hospital, College of Medicine, Zhejiang University. Twenty-two beta-lactamase genes were analyzed by PCR and verified by DNA sequencing. Enzyme activities of extended spectrum beta-lactamases (ESBLs) , cephalosporinase ( AmpC) and metallo-beta-lactamases ( MBL) were detected by the modified three-dimensional method using enzyme extraction. Results In 62 MDRABs, 51 (82.3% ) , 50 (80.6% ) and 36 (58.1% ) isolates were found to carry blaTEM, blaOXA-23 cluster, and blaADC, respectively. The rest 19 genes were not detected in this study. DNA sequencing and genomic comparison showed that 5 isolates carrying blaTEM had the same genotype as blaTEM-l , 6 isolates carrying blaOXA-23 cluster had the same genotype as blaOXA-23 carbapenemases (accession; CAB69042. 1) , and 2 isolates carrying blaADC had the same genotype as blaADC-like (accession: EU081908). Thirty-two isolates (51.6% ) produced ESBLs and AmpC, 19 isolates (30.6% ) produced ESBLs only, and 1 isolate (1.6%) produced AmpC only; and no isolate produced MBL. Conclusion MDRAB carrying blaOXA-23 carbapenemase and blaADC AmpC in this study are of high drug resistance.
