CAJ | 학술논문

目的探讨我国多药耐药鲍曼不动杆菌(鲍氏不动杆菌,MDR-AB)AdeB外排系统对碳青霉烯类抗生素耐药的介导作用.方法选取全国21家医院MDR-AB菌株101株和敏感菌株12株,用琼脂稀释法检测外排泵抑制剂苯丙氨酸-精氨酸-β-苯胺(PAβN,50 mg/L)对菌株AdeB外排系统的抑制作用及菌株对亚胺培南和美罗培南的耐药情况.利用实时荧光定量PCR技术分析adeB的表达情况,并探讨其与外排表型及耐药之间的关系.结果 101株MDR-AB对亚胺培南和美罗培南的耐药率分别为62.4％和52.5％.1 13株菌株中,共有82株adeB阳性菌株,其中adeB表达比率＞2.5的7株菌株均表现为多重耐药.亚胺培南的耐药组和非耐药组adeB的表达比率分别为1.237±0.159和0.698±0.115,差异有统计学意义(t=2.641,P＜0.05)；而美罗培南耐药组和非耐药组adeB的表达比率分别为1.013±0.148和0.978±0.150,组间差异无统计学意义(t=0.166,P＞0.05).结论我国MDR-AB中,AdeB外排泵系统的过度表达介导了其对亚胺培南耐药,并可能和美罗培南耐药有关.
목적 탐토아국다약내약포만불동간균(포씨불동간균,MDR-AB)AdeB외배계통대탄청매희류항생소내약적개도작용.방법 선취전국21가의원MDR-AB균주101주화민감균주12주,용경지희석법검측외배빙억제제분병안산-정안산-β-분알(PAβN,50 mg/L)대균주AdeB외배계통적억제작용급균주대아알배남화미라배남적내약정황.이용실시형광정량PCR기술분석adeB적표체정황,병탐토기여외배표형급내약지간적관계.결과 101주MDR-AB대아알배남화미라배남적내약솔분별위62.4％화52.5％.1 13주균주중,공유82주adeB양성균주,기중adeB표체비솔＞2.5적7주균주균표현위다중내약.아알배남적내약조화비내약조adeB적표체비솔분별위1.237±0.159화0.698±0.115,차이유통계학의의(t=2.641,P＜0.05)；이미라배남내약조화비내약조adeB적표체비솔분별위1.013±0.148화0.978±0.150,조간차이무통계학의의(t=0.166,P＞0.05).결론 아국MDR-AB중,AdeB외배빙계통적과도표체개도료기대아알배남내약,병가능화미라배남내약유관.
Objective To investigate the role of AdeB efflux system of multidrug resistant Acinetobacter baumannii (MDR-AB) in carbapenem resistance.Methods One hundred and one isolates of MDR-AB and 12 isolates of antibiotic susceptible Acinetobacter baumannii were collected from 21 hospitals in China.Agar dilution method was used to evaluate the inhibitory effect of efflux pump inhibitor phenyl-arginine-β-naphthylamide (PAβN,50 mg/L) on AdeB-mediated efflux and the drug resistance of MDR-AB to imipenem and meropenem.Real time-PCR was used to determine the expression of adeB gene.Results The resistance rates of 101 MDR-AB isolates to imipenem and meropenem were 62.4％ and 52.5％,respectively.Of 113 isolates,82 were adeB gene positive,7 of which showed significantly high adeB expression (expression rate ＞2.5) and were all MDR-AB.The ratio of adeB expression was significantly different between resistant isolates (1.237±0.159) and susceptible isolates (0.698±0.115) of imipenem (t=2.641,P＜0.05),but no significant difference was noted between resistant isolates (1.013±0.148) and susceptible isolates (0.978±0.150) of meropenem (t=0.166,P＞0.05).Conclusions The over expression of AdeB efflux pump may play a role in imipenem resistance in MDR-AB but its effect on meropenem resistance is uncertain.