中国临床药理学杂志
中國臨床藥理學雜誌
중국림상약이학잡지
THE CHINESE JOURNAL OF CLINICAL PHARMACOLOGY
2014年
4期
332-336
,共5页
鲍曼不动杆菌%碳青霉烯类%脉冲场凝胶电泳%分子流行病学
鮑曼不動桿菌%碳青黴烯類%脈遲場凝膠電泳%分子流行病學
포만불동간균%탄청매희류%맥충장응효전영%분자류행병학
Acinetobacter baumannii%carbapenemase%pulsed field gel electrophoresis%molecular epidemiology
目的：调查重症监护病房（ICU）耐碳青霉烯鲍曼不动杆菌（CRAB）的药物敏感性及其分子特征。方法收集2010年深圳市人民医院ICU患者分离CRAB 48株，琼脂稀释法测定亚胺培南等15种抗菌药对CRAB的最低抑菌浓度（MIC），聚合酶链式反应（PCR）和DNA测序分析CRAB碳青霉烯酶基因型，脉冲场凝胶电泳（ PFGE）分析菌株同源性。结果多黏菌素B对48株CRAB抗菌活性最高（敏感性为100％）， MIC50/MIC90均为1μg · mL-1，其次为米诺环素，敏感性为95.8％，MIC50/MIC90均为4μg· mL-1，43株CRAB对替加环素中介，MIC50/MIC90均为4μg· mL-1。43株CRAB携带blaOXA-23-like ，对亚胺培南和美罗培南高度耐药，其MIC在16～64μg· mL-1；3株CRAB携带blaOXA-58-like，2株CRAB携带ISAba1-blaOXA-51-like ，亚胺培南和美罗培南的MIC在8～16μg· mL-1。48株CRAB扩增blaOXA-24-like、blaOXA-143-like、金属酶基因及KPC酶基因均阴性。48株CRAB经PFGE分型共分4型，以A型42株（87.5％）为主要流行克隆，均携带blaOXA-23-like。结论2010年携带blaOXA-23-like的CRAB高耐药克隆在我院ICU流行。
目的：調查重癥鑑護病房（ICU）耐碳青黴烯鮑曼不動桿菌（CRAB）的藥物敏感性及其分子特徵。方法收集2010年深圳市人民醫院ICU患者分離CRAB 48株，瓊脂稀釋法測定亞胺培南等15種抗菌藥對CRAB的最低抑菌濃度（MIC），聚閤酶鏈式反應（PCR）和DNA測序分析CRAB碳青黴烯酶基因型，脈遲場凝膠電泳（ PFGE）分析菌株同源性。結果多黏菌素B對48株CRAB抗菌活性最高（敏感性為100％）， MIC50/MIC90均為1μg · mL-1，其次為米諾環素，敏感性為95.8％，MIC50/MIC90均為4μg· mL-1，43株CRAB對替加環素中介，MIC50/MIC90均為4μg· mL-1。43株CRAB攜帶blaOXA-23-like ，對亞胺培南和美囉培南高度耐藥，其MIC在16～64μg· mL-1；3株CRAB攜帶blaOXA-58-like，2株CRAB攜帶ISAba1-blaOXA-51-like ，亞胺培南和美囉培南的MIC在8～16μg· mL-1。48株CRAB擴增blaOXA-24-like、blaOXA-143-like、金屬酶基因及KPC酶基因均陰性。48株CRAB經PFGE分型共分4型，以A型42株（87.5％）為主要流行剋隆，均攜帶blaOXA-23-like。結論2010年攜帶blaOXA-23-like的CRAB高耐藥剋隆在我院ICU流行。
목적：조사중증감호병방（ICU）내탄청매희포만불동간균（CRAB）적약물민감성급기분자특정。방법수집2010년심수시인민의원ICU환자분리CRAB 48주，경지희석법측정아알배남등15충항균약대CRAB적최저억균농도（MIC），취합매련식반응（PCR）화DNA측서분석CRAB탄청매희매기인형，맥충장응효전영（ PFGE）분석균주동원성。결과다점균소B대48주CRAB항균활성최고（민감성위100％）， MIC50/MIC90균위1μg · mL-1，기차위미낙배소，민감성위95.8％，MIC50/MIC90균위4μg· mL-1，43주CRAB대체가배소중개，MIC50/MIC90균위4μg· mL-1。43주CRAB휴대blaOXA-23-like ，대아알배남화미라배남고도내약，기MIC재16～64μg· mL-1；3주CRAB휴대blaOXA-58-like，2주CRAB휴대ISAba1-blaOXA-51-like ，아알배남화미라배남적MIC재8～16μg· mL-1。48주CRAB확증blaOXA-24-like、blaOXA-143-like、금속매기인급KPC매기인균음성。48주CRAB경PFGE분형공분4형，이A형42주（87.5％）위주요류행극륭，균휴대blaOXA-23-like。결론2010년휴대blaOXA-23-like적CRAB고내약극륭재아원ICU류행。
Objective To investigate the susceptibility of antimicrobial agents, carbapenemase genotypes and clonal relatedness among carbap-enem-resistant Acinetobacter baumannii ( CRAB) isolated from intensive care unit ( ICU) in Shenzhen People′s Hospital.Methods Forty-eight non-duplicated CRAB isolates were collected from ICU in this hospital in 2010.The minimum inhibitory concentrations ( MICs) of fifteen anti-microbial agents against CRAB were detected by agar dilution method.Polymerase chain reaction ( PCR) and DNA sequencing were used to in-vestigate the carbapenemase genotype among CRAB.All isolates were typed by pulse field gel electrophoresis ( PFGE ).Results Polymixin B showed the highest activity against forty-eight CRAB isolates ( suscepti-bility of 100%) , with the MIC50/MIC90 of 1 μg· mL -1 , followed by mi-nocycline (susceptibility of 95.8%), with the MIC50/MIC90 of 4 μg· mL -1, and tigecycline (intermediate of 89.6%), with the MIC50/MIC90 of 4 μg· mL-1 , respectively.Approximately ninety percent (43/48 ) of CRAB isolates harbored blaOXA-23-like , which showed high resistance to imipenem and meropenem , with the main distribution of MICs ranging from 16 to 64 μg · mL-1.Three and two CRAB isolates harbored blaOXA-58-like and ISAba1-blaOXA-51-like, respectively.Both of them exhibited intermediate resistance against imipenem and meropenem, with the main distribution of MICs ranging from 8 to 16 μg· mL-1.blaOXA-24-like, blaOXA-143-like, metallo-β-lactamase and KPC genes were not detected in any of isolates.Four distinct PFGE patterns were observed among forty-eight isolates of CRAB.All of type A isolates harbored blaOXA-23-like , accounting for 87.5%(42/48) of CRAB.Conclusion The spread of CRAB clone harboring blaOXA-23-like occurred in ICU of our hospital during 2010.
