南方医科大学学报
南方醫科大學學報
남방의과대학학보
JOURNAL OF SOUTHERN MEDICAL UNIVERSITY
2009年
7期
1393-1396
,共4页
鲍曼不动杆菌%碳青霉烯酶类%OXA-58
鮑曼不動桿菌%碳青黴烯酶類%OXA-58
포만불동간균%탄청매희매류%OXA-58
A cinetobacter baumannii%carbapenemases%OXA-58
目的 调查和研究西安地区鲍曼不动杆菌对碳青霉烯类抗生素耐药分子机制和产碳青霉烯酶情况.方法 收集西安地区六所三级甲等医院一年间临床分离的非重复鲍曼不动杆菌株146株,采用K-B法进行药敏试验,E-test法检测金属酶,NaCl抑制试验检测OXA型碳青霉烯酶,PCR扩增OXA-23、OXA-58型碳青霉烯酶基因,其阳性产物经双向测序分析.结果 筛选出对亚胺培南耐药的鲍曼不动杆菌非重复株15株,14株耐药菌经E-test法鉴定未产金属酶,经NaCl抑制后发现其对亚胺培南的敏感性增加,提示产生OXA型碳青霉烯酶,其中11株PCR扩增bla_(OXA-23)阳性,1株PCR扩增bla_(OXA-58)阳性,NaCl抑制试验与PCR检测结果的一致率达85.7%.结论 产OXA型碳青霉烯酶是西安地区该菌对亚胺培南耐药的主要原因,其OXA-58型基因在国内尚属新型碳青霉烯酶基因型;NaCl抑制试验是一种简单、有效、价廉的表型筛选OXA型碳青霉烯酶的新方法.
目的 調查和研究西安地區鮑曼不動桿菌對碳青黴烯類抗生素耐藥分子機製和產碳青黴烯酶情況.方法 收集西安地區六所三級甲等醫院一年間臨床分離的非重複鮑曼不動桿菌株146株,採用K-B法進行藥敏試驗,E-test法檢測金屬酶,NaCl抑製試驗檢測OXA型碳青黴烯酶,PCR擴增OXA-23、OXA-58型碳青黴烯酶基因,其暘性產物經雙嚮測序分析.結果 篩選齣對亞胺培南耐藥的鮑曼不動桿菌非重複株15株,14株耐藥菌經E-test法鑒定未產金屬酶,經NaCl抑製後髮現其對亞胺培南的敏感性增加,提示產生OXA型碳青黴烯酶,其中11株PCR擴增bla_(OXA-23)暘性,1株PCR擴增bla_(OXA-58)暘性,NaCl抑製試驗與PCR檢測結果的一緻率達85.7%.結論 產OXA型碳青黴烯酶是西安地區該菌對亞胺培南耐藥的主要原因,其OXA-58型基因在國內尚屬新型碳青黴烯酶基因型;NaCl抑製試驗是一種簡單、有效、價廉的錶型篩選OXA型碳青黴烯酶的新方法.
목적 조사화연구서안지구포만불동간균대탄청매희류항생소내약분자궤제화산탄청매희매정황.방법 수집서안지구륙소삼급갑등의원일년간림상분리적비중복포만불동간균주146주,채용K-B법진행약민시험,E-test법검측금속매,NaCl억제시험검측OXA형탄청매희매,PCR확증OXA-23、OXA-58형탄청매희매기인,기양성산물경쌍향측서분석.결과 사선출대아알배남내약적포만불동간균비중복주15주,14주내약균경E-test법감정미산금속매,경NaCl억제후발현기대아알배남적민감성증가,제시산생OXA형탄청매희매,기중11주PCR확증bla_(OXA-23)양성,1주PCR확증bla_(OXA-58)양성,NaCl억제시험여PCR검측결과적일치솔체85.7%.결론 산OXA형탄청매희매시서안지구해균대아알배남내약적주요원인,기OXA-58형기인재국내상속신형탄청매희매기인형;NaCl억제시험시일충간단、유효、개렴적표형사선OXA형탄청매희매적신방법.
Objective To investigate the molecular mechanism of carbapenem resistance in the clinical isolates of A cinetobacter baumannii from Xi'an and their profile of carbapenemase production. Methods A total of 146 A cinetobacter baumannii strains were isolated from 6 general hospitals in Xi'an.Antimicrobial susceptibility test was performed for all the strains,followed by detection of imipenem resistance using E-test for metallo-β-lactamase(MBL)and NaCl inhibition test for OXA type carbapenemase.Bla_(OXA-23) and bla_(OXA-58) were amplified by PCR,and the positive products were sequenced.Results From the collected strains,15 non-repetitive imipenem-resistant A cinetobacter baumannii strains were identified,among which 14 yielded negative results in E-test for MBL production. All the resistant strains showed increased sensitivity to imipenem after NaCl inhibition.suggesting the presence of carbapenemase production.Eleven of the strains harbored OXA-23 type gene and 1 harbored OXA-58 type gene.The concordance rate of the results by NaCl inhibition test and PCR was 85.7%. Conclusions Production Of OXA-type carbapenemases is the most important reason for carbapemen resistance in A cinetobacter baumannii in Xi'an.The OXA-58 type gene is a novel carbapenemase genotype in China.NaCl inhibition test is a convenient and cost-effective method for detecting carbapenemases in A cinetobacter baumzmnii.
