目的 探讨临床分离鲍曼不动杆菌菌株生物膜形成能力及生物膜相关基因的分布情况,分析其与细菌耐药表型的关系.方法 采用前瞻性研究方法,收集山东省成武县人民医院2012年10月至2013年10月分离的70株鲍曼不动杆菌,采用96孔聚苯乙烯板构建生物膜模型,结晶紫染色法定性、定量分析生物膜形成能力,比较不同生物膜形成能力鲍曼不动杆菌对亚胺培南、阿米卡星、美罗培南、头孢吡肟、头孢哌酮舒巴坦、甲氧苄啶、左氧氟沙星、庆大霉素、环丙沙星、头孢噻肟、头孢唑肟、氨曲南、哌拉西啉、头孢曲松、头孢呋辛等15种抗菌药物的耐药性.运用聚合酶链反应(PCR)技术扩增及检测生物膜相关基因Bap、bfs和intI1的表达.结果 70株鲍曼不动杆菌中40株为多重耐药菌(57.14％),6株为泛耐药菌(8.57％).68株具有生物膜形成能力(97.14％),其中弱阳性14株,阳性20株,强阳性34株.鲍曼不动杆菌对亚胺培南、阿米卡星、美罗培南、头孢吡肟的耐药率较低,分别为30.00％、32.86％、38.57％及41.43％,对其他常用抗菌药物的耐药率均在50％以上.随着生物膜形成能力的增强(弱阳性、阳性、强阳性),鲍曼不动杆菌对左氧氟沙星(85.71％、45.00％、38.24％,x2=9.225,P=0.010)、头孢吡肟(71.43％、45.00％、29.41％,x2=7.222,P=0.027)、庆大霉素(78.57％、55.00％、38.24％,x2=6.601,P=0.037)的耐药率显著降低.生物膜呈弱阳性、阳性和强阳性的鲍曼不动杆菌Bap基因阳性率分别为50.00％、65.00％和79.41％ (x2 =4.244,P=0.120),bfs基因阳性率分别为35.71％、65.00％和88.24％(x2=13.602,P=0.001),intI1基因阳性率分别为42.86％、75.00％和91.18％(x2=12.902,P=0.002).生物膜相关基因阳性组对抗菌药物耐药率大多高于基因阴性组,但仅intI1基因阳性组对阿米卡星的耐药率显著高于基因阴性组(40.38％比11.11％,x2=5.194,P=0.023).结论 鲍曼不动杆菌多重耐药情况严峻,且生物膜形成能力较强,随着生物膜形成能力的增强其耐药性降低;Bap、bfs、intI1基因参与了生物膜的形成.
目的 探討臨床分離鮑曼不動桿菌菌株生物膜形成能力及生物膜相關基因的分佈情況,分析其與細菌耐藥錶型的關繫.方法 採用前瞻性研究方法,收集山東省成武縣人民醫院2012年10月至2013年10月分離的70株鮑曼不動桿菌,採用96孔聚苯乙烯闆構建生物膜模型,結晶紫染色法定性、定量分析生物膜形成能力,比較不同生物膜形成能力鮑曼不動桿菌對亞胺培南、阿米卡星、美囉培南、頭孢吡肟、頭孢哌酮舒巴坦、甲氧芐啶、左氧氟沙星、慶大黴素、環丙沙星、頭孢噻肟、頭孢唑肟、氨麯南、哌拉西啉、頭孢麯鬆、頭孢呋辛等15種抗菌藥物的耐藥性.運用聚閤酶鏈反應(PCR)技術擴增及檢測生物膜相關基因Bap、bfs和intI1的錶達.結果 70株鮑曼不動桿菌中40株為多重耐藥菌(57.14％),6株為汎耐藥菌(8.57％).68株具有生物膜形成能力(97.14％),其中弱暘性14株,暘性20株,彊暘性34株.鮑曼不動桿菌對亞胺培南、阿米卡星、美囉培南、頭孢吡肟的耐藥率較低,分彆為30.00％、32.86％、38.57％及41.43％,對其他常用抗菌藥物的耐藥率均在50％以上.隨著生物膜形成能力的增彊(弱暘性、暘性、彊暘性),鮑曼不動桿菌對左氧氟沙星(85.71％、45.00％、38.24％,x2=9.225,P=0.010)、頭孢吡肟(71.43％、45.00％、29.41％,x2=7.222,P=0.027)、慶大黴素(78.57％、55.00％、38.24％,x2=6.601,P=0.037)的耐藥率顯著降低.生物膜呈弱暘性、暘性和彊暘性的鮑曼不動桿菌Bap基因暘性率分彆為50.00％、65.00％和79.41％ (x2 =4.244,P=0.120),bfs基因暘性率分彆為35.71％、65.00％和88.24％(x2=13.602,P=0.001),intI1基因暘性率分彆為42.86％、75.00％和91.18％(x2=12.902,P=0.002).生物膜相關基因暘性組對抗菌藥物耐藥率大多高于基因陰性組,但僅intI1基因暘性組對阿米卡星的耐藥率顯著高于基因陰性組(40.38％比11.11％,x2=5.194,P=0.023).結論 鮑曼不動桿菌多重耐藥情況嚴峻,且生物膜形成能力較彊,隨著生物膜形成能力的增彊其耐藥性降低;Bap、bfs、intI1基因參與瞭生物膜的形成.
목적 탐토림상분리포만불동간균균주생물막형성능력급생물막상관기인적분포정황,분석기여세균내약표형적관계.방법 채용전첨성연구방법,수집산동성성무현인민의원2012년10월지2013년10월분리적70주포만불동간균,채용96공취분을희판구건생물막모형,결정자염색법정성、정량분석생물막형성능력,비교불동생물막형성능력포만불동간균대아알배남、아미잡성、미라배남、두포필우、두포고동서파탄、갑양변정、좌양불사성、경대매소、배병사성、두포새우、두포서우、안곡남、고랍서람、두포곡송、두포부신등15충항균약물적내약성.운용취합매련반응(PCR)기술확증급검측생물막상관기인Bap、bfs화intI1적표체.결과 70주포만불동간균중40주위다중내약균(57.14％),6주위범내약균(8.57％).68주구유생물막형성능력(97.14％),기중약양성14주,양성20주,강양성34주.포만불동간균대아알배남、아미잡성、미라배남、두포필우적내약솔교저,분별위30.00％、32.86％、38.57％급41.43％,대기타상용항균약물적내약솔균재50％이상.수착생물막형성능력적증강(약양성、양성、강양성),포만불동간균대좌양불사성(85.71％、45.00％、38.24％,x2=9.225,P=0.010)、두포필우(71.43％、45.00％、29.41％,x2=7.222,P=0.027)、경대매소(78.57％、55.00％、38.24％,x2=6.601,P=0.037)적내약솔현저강저.생물막정약양성、양성화강양성적포만불동간균Bap기인양성솔분별위50.00％、65.00％화79.41％ (x2 =4.244,P=0.120),bfs기인양성솔분별위35.71％、65.00％화88.24％(x2=13.602,P=0.001),intI1기인양성솔분별위42.86％、75.00％화91.18％(x2=12.902,P=0.002).생물막상관기인양성조대항균약물내약솔대다고우기인음성조,단부intI1기인양성조대아미잡성적내약솔현저고우기인음성조(40.38％비11.11％,x2=5.194,P=0.023).결론 포만불동간균다중내약정황엄준,차생물막형성능력교강,수착생물막형성능력적증강기내약성강저;Bap、bfs、intI1기인삼여료생물막적형성.
Objective To study the biofilm-forming ability and the distribution of biofilm-related genes in Acinetobacter baumannii clinical isolates as well as antimicrobial resistance,to analyze their relationships with the bacterial resistance phenotype.Methods A prospective study was conducted.Biofilm models of 70 strains Acinetobacter baumannii collected in Chengwu County People's Hospital from October 2012 to October 2013 were constructed using 96-well polystyrene plate.In order to analyze the biofilm-forming ability,a qualitative and quantitative analysis was conduct by crystal violet staining assay.And the antimicrobial resistance of different biofilm-forming ability strains was compared including imipenem,amikacin,meropenem,cefepime,sulbactam cefoperazone,trimethoprim,levofloxacin,gentamicin,ciprofloxacin,cefotaxime,ceftizoxime,aztreonam,piperacillin,ceftriaxone,cefuroxime.In addition,the expressions of biofilm-related gene Bap,bfs and intI1 were tested with polymerase chain reaction (PCR) assay.Results Among 70 strains Acinetobacter baumannii,40 strains were multi-drug resistant (57.14％) and 6 strains were pan-drug resistant (8.57％); 68 strains had biofilm-forming ability (97.14％),14 of which were weakly positive,20 were positive and 34 were strongly positive.The antimicrobial resistant rate of Acinetobacter baumannii to imipenem,amikacin,meropenem and cefepime was decreased,it was 30.00％,32.86％,38.57％ and 41.43％,respectively.However,the antimicrobial resistant rates to other commonly used antibiotics were all higher than 50％.The drug resistance of Acinetobacter baumannii to levofloxacin (85.71％,45.00％,38.24％,x2=9.225,P=0.010),cefepime (71.43％,45.00％,29.41％,x2=7.222,P=0.027),gentamicin (78.57％,55.00％,38.24％,x2 =6.601,P=0.037) was significantly decreased when biofilm-forming ability reinforced (weakly positive,positive,hadro-positive).Bap gene positive rate of weakly positive,positive and strong positive biofilm-forming strains Acinetobacter baumannii was 50.00％,65.00％ and 79.41％ (x2=4.244,P=0.120),respectively.Bfs gene positive rate was 35.71％,65.00％ and 88.24％,respectively (x2=13.602,P=0.001) and intI1 gene positive rate was 42.86％,75.00％ and 91.18％,respectively (x2 =12.902,P=0.002).Moreover,the antimicrobial resistances of biofilm-related gene positive strains were higher than the negative,of which the drug resistance of intI1 positive group to amikacin was significantly higher than the negative group (40.38％ vs.11.11％,x 2=5.194,P=0.023).Conclusions The Acinetobacter baumannii collected from the hospital had strong multi-drug resistance as well as strong biofilm-forming ability.The drug resistance of Acinetobacter baumannii decreased when biofilm-forming ability reinforced.In addition,genes,such as Bap,bfs,and intI1,contributed to biofilm formation.
