检验医学
檢驗醫學
검험의학
LABORATORY MEDICINE
2013年
11期
1008-1011
,共4页
广泛耐药鲍曼不动杆菌%氨基糖苷类修饰酶%获得性耐药基因%序列分析
廣汎耐藥鮑曼不動桿菌%氨基糖苷類脩飾酶%穫得性耐藥基因%序列分析
엄범내약포만불동간균%안기당감류수식매%획득성내약기인%서렬분석
Extensively drug-resistant Acintobacter baumannii%Aminoglycoside modifying enzyme%Acquired resistant gene%Sequencing analysis
目的：了解重症监护病房（ICU）患者分离的广泛耐药（XDR）-鲍曼不动杆菌（AB）对氨基糖苷类药物获得性耐药基因情况。方法用phoenixTM-100全自动细菌鉴定药物敏感性分析仪对AB进行细菌鉴定和药物敏感性试验，gyrA和parC基因扩增测序确定AB。聚合酶链反应（PCR）测定20株XDR-AB的10种氨基糖苷类修饰酶基因、6种16S rRNA甲基化酶基因和外排泵adeB基因，并用DNA测序比对。结果20株XDR-AB中，氨基糖苷类修饰酶基因aac（3）-Ⅰ、aac（6′）-Ⅰb、ant（3″）-Ⅰ、aph（3′）-Ⅰ检出率分别为90．0％、30．0％、95．0％、95．0％，而aac（3）-Ⅱ、aac（6′）-Ⅰad、aac（6′）-Ⅱ、ant（2″）-Ⅰ、ant（4′）-Ⅰ及aph（3′）-Ⅵa基因均未检出。armA型16S rRNA甲基化酶基因和外排泵adeB基因检出率均为100％。结论20株XDR-AB均携带了armA和adeB基因，同时aac（3）-Ⅰ、ant（3″）-Ⅰ和aph（3）-Ⅰ检出率较高，提示ICU分离的XDR-AB对氨基糖苷类药物高水平耐药可能与携带的耐药基因有关。
目的：瞭解重癥鑑護病房（ICU）患者分離的廣汎耐藥（XDR）-鮑曼不動桿菌（AB）對氨基糖苷類藥物穫得性耐藥基因情況。方法用phoenixTM-100全自動細菌鑒定藥物敏感性分析儀對AB進行細菌鑒定和藥物敏感性試驗，gyrA和parC基因擴增測序確定AB。聚閤酶鏈反應（PCR）測定20株XDR-AB的10種氨基糖苷類脩飾酶基因、6種16S rRNA甲基化酶基因和外排泵adeB基因，併用DNA測序比對。結果20株XDR-AB中，氨基糖苷類脩飾酶基因aac（3）-Ⅰ、aac（6′）-Ⅰb、ant（3″）-Ⅰ、aph（3′）-Ⅰ檢齣率分彆為90．0％、30．0％、95．0％、95．0％，而aac（3）-Ⅱ、aac（6′）-Ⅰad、aac（6′）-Ⅱ、ant（2″）-Ⅰ、ant（4′）-Ⅰ及aph（3′）-Ⅵa基因均未檢齣。armA型16S rRNA甲基化酶基因和外排泵adeB基因檢齣率均為100％。結論20株XDR-AB均攜帶瞭armA和adeB基因，同時aac（3）-Ⅰ、ant（3″）-Ⅰ和aph（3）-Ⅰ檢齣率較高，提示ICU分離的XDR-AB對氨基糖苷類藥物高水平耐藥可能與攜帶的耐藥基因有關。
목적：료해중증감호병방（ICU）환자분리적엄범내약（XDR）-포만불동간균（AB）대안기당감류약물획득성내약기인정황。방법용phoenixTM-100전자동세균감정약물민감성분석의대AB진행세균감정화약물민감성시험，gyrA화parC기인확증측서학정AB。취합매련반응（PCR）측정20주XDR-AB적10충안기당감류수식매기인、6충16S rRNA갑기화매기인화외배빙adeB기인，병용DNA측서비대。결과20주XDR-AB중，안기당감류수식매기인aac（3）-Ⅰ、aac（6′）-Ⅰb、ant（3″）-Ⅰ、aph（3′）-Ⅰ검출솔분별위90．0％、30．0％、95．0％、95．0％，이aac（3）-Ⅱ、aac（6′）-Ⅰad、aac（6′）-Ⅱ、ant（2″）-Ⅰ、ant（4′）-Ⅰ급aph（3′）-Ⅵa기인균미검출。armA형16S rRNA갑기화매기인화외배빙adeB기인검출솔균위100％。결론20주XDR-AB균휴대료armA화adeB기인，동시aac（3）-Ⅰ、ant（3″）-Ⅰ화aph（3）-Ⅰ검출솔교고，제시ICU분리적XDR-AB대안기당감류약물고수평내약가능여휴대적내약기인유관。
Objective To investigate the situation of acquired resistant genes against aminoglycosides in extensively drug-resistant (XDR)Acintobacter baumannii (AB)isolated from intensive care unit (ICU)patients.Methods Bacterial identification and susceptibility tests of AB were performed by phoenixTM-1 00 automatic bacterial identification and susceptibility analyzer,and the AB identification was confirmed by gyrA and parC gene amplification sequencing. For the 20 isolates of XDR-AB,1 0 aminoglycoside modifying enzyme genes,6 1 6S rRNA methylase genes and efflux pump adeB genes were detected by polymerase chain reaction(PCR)and verified and compared by DNA sequencing. Results Of the 20 isolates of XDR-AB,the detection rates of aac(3)-Ⅰ,aac(6′)-Ⅰb,ant(3″)-Ⅰ and aph(3′)-Ⅰgenes were 90.0%,30.0%,95.0% and 95.0%,respectively.However,aac(3)-Ⅱ,aac(6′)-Ⅰad,aac(6′)-Ⅱ,ant (2″)-Ⅰ,ant(4′)-Ⅰand aph(3′)-Ⅵa genes were not found.In addition,the armA 1 6S rRNA methylase gene and efflux pump adeB genes existed in all of the 20 isolates,and the detection rates were 1 00%.Conclusions All of the 20 isolates of XDR-AB carry not only armA and adeB genes but also a large amount of aac(3)-Ⅰ,ant(3″)-Ⅰand aph(3)-Ⅰgenes.It indicates that the high-level resistance to aminoglycosides in XDR-AB isolated from ICU may be associated with the resistant genes.
