医药导报
醫藥導報
의약도보
HERALD OF MEDICINE
2014年
5期
579-581
,共3页
赵雪%于沛涛%徐芝君%顾清%裘力锋%王弋
趙雪%于沛濤%徐芝君%顧清%裘力鋒%王弋
조설%우패도%서지군%고청%구력봉%왕익
鲍曼不动杆菌%氨基苷钝化酶基因%16S rRNA甲基化酶基因%重症监护病房,急诊
鮑曼不動桿菌%氨基苷鈍化酶基因%16S rRNA甲基化酶基因%重癥鑑護病房,急診
포만불동간균%안기감둔화매기인%16S rRNA갑기화매기인%중증감호병방,급진
Acinetobacter baumannii%Aminoglycoside-passivating enzymes genes%16S rRNA methylase gene%Intensive care unit,emergency
目的:研究急诊重症监护病房(EICU)感染患者鲍曼不动杆菌16S rRNA甲基化酶armA、氨基苷核苷转移酶ANT(3'')-Ia、氨基苷磷酸转移酶APH(3')-I、氨基苷乙酰转移酶AAC(6')-Ib检出率,分析耐氨基苷鲍曼不动杆菌的耐药机制。方法收集48株鲍曼不动杆菌均经VITEK系统鉴定,并采用琼脂对倍稀释法测定最低抑菌浓度( MIC),采用聚合酶链反应( PCR)法检测酶基因。结果48株鲍曼不动杆菌中氨基苷类抗菌药物高耐药菌株28株,低耐药菌株20株。高耐药菌16S rRNA armA和低耐药菌16S rRNA armA检出率分别为71.43%和0.00%(P<0.01),高耐药菌APH (3')-I和低耐药菌APH(3')-I检出率分别为60.71%和0.05%(P<0.01),高耐药菌ANT(3'')-Ia和低耐药菌ANT(3'')-Ia检出率分别为82.14%和0.05%(P<0.01),高耐药菌AAC(6')-Ib和低耐药菌AAC(6')-Ib检出率分别为53.57%和0.05%(P<0.01)。结论氨基苷钝化酶和16S rRNA甲基化酶在氨基苷高耐药鲍曼不动杆菌中检出率高,与氨基苷类抗菌药物高耐药密切相关。
目的:研究急診重癥鑑護病房(EICU)感染患者鮑曼不動桿菌16S rRNA甲基化酶armA、氨基苷覈苷轉移酶ANT(3'')-Ia、氨基苷燐痠轉移酶APH(3')-I、氨基苷乙酰轉移酶AAC(6')-Ib檢齣率,分析耐氨基苷鮑曼不動桿菌的耐藥機製。方法收集48株鮑曼不動桿菌均經VITEK繫統鑒定,併採用瓊脂對倍稀釋法測定最低抑菌濃度( MIC),採用聚閤酶鏈反應( PCR)法檢測酶基因。結果48株鮑曼不動桿菌中氨基苷類抗菌藥物高耐藥菌株28株,低耐藥菌株20株。高耐藥菌16S rRNA armA和低耐藥菌16S rRNA armA檢齣率分彆為71.43%和0.00%(P<0.01),高耐藥菌APH (3')-I和低耐藥菌APH(3')-I檢齣率分彆為60.71%和0.05%(P<0.01),高耐藥菌ANT(3'')-Ia和低耐藥菌ANT(3'')-Ia檢齣率分彆為82.14%和0.05%(P<0.01),高耐藥菌AAC(6')-Ib和低耐藥菌AAC(6')-Ib檢齣率分彆為53.57%和0.05%(P<0.01)。結論氨基苷鈍化酶和16S rRNA甲基化酶在氨基苷高耐藥鮑曼不動桿菌中檢齣率高,與氨基苷類抗菌藥物高耐藥密切相關。
목적:연구급진중증감호병방(EICU)감염환자포만불동간균16S rRNA갑기화매armA、안기감핵감전이매ANT(3'')-Ia、안기감린산전이매APH(3')-I、안기감을선전이매AAC(6')-Ib검출솔,분석내안기감포만불동간균적내약궤제。방법수집48주포만불동간균균경VITEK계통감정,병채용경지대배희석법측정최저억균농도( MIC),채용취합매련반응( PCR)법검측매기인。결과48주포만불동간균중안기감류항균약물고내약균주28주,저내약균주20주。고내약균16S rRNA armA화저내약균16S rRNA armA검출솔분별위71.43%화0.00%(P<0.01),고내약균APH (3')-I화저내약균APH(3')-I검출솔분별위60.71%화0.05%(P<0.01),고내약균ANT(3'')-Ia화저내약균ANT(3'')-Ia검출솔분별위82.14%화0.05%(P<0.01),고내약균AAC(6')-Ib화저내약균AAC(6')-Ib검출솔분별위53.57%화0.05%(P<0.01)。결론안기감둔화매화16S rRNA갑기화매재안기감고내약포만불동간균중검출솔고,여안기감류항균약물고내약밀절상관。
Objective To investigate drug resistance mechanism of aminoglycoside-resistant Acinetobacter baumannii by detecting 16S rRNA methylase gene and three common genes of aminoglycoside-modifying enzymes in Acinetobacter baumannii infected patients at EICU. Methods The 48 Acinetobacter baumannii strains were collected,and antimicrobial susceptibility tests were performed by VITEK automicroscan. The MIC was detected by 2-fold agar dilution method,and genes were analyzed by polymerase chain reaction( PCR) . Results Among 48 strains,28 were highly resistant to aminoglycosides and 20 showed lower resistances. The 16S rRNA armA,APH(3')-I,ANT(3'')-Ia,AAC(6')-Ib genes were detected in 71. 43%,60. 71%,82. 14%, and 53. 57%of the 28 highly resistant strains,but only present in 0. 00%,0. 05%,0. 05%,and 0. 05%of the low-resistant isolates(P<0. 01). Conclusion The aminoglycoside-modifying enzymes and 16S rRNA methylase were frequently found in Acinetobacter baumannii clinical isolates,which is closely related to the high-level resistance to aminoglycoside antibiotics.