中国感染与化疗杂志
中國感染與化療雜誌
중국감염여화료잡지
CHINESE JOURNAL OF INFECTION AND CHEMOTHERAPY
2015年
1期
28-31
,共4页
广泛耐药%鲍曼不动杆菌%同源性%耐药基因
廣汎耐藥%鮑曼不動桿菌%同源性%耐藥基因
엄범내약%포만불동간균%동원성%내약기인
extensively drug-resistant%Acinetobacter baumannii%homology%drug-resistant gene
目的：了解上海市同仁医院临床分离广泛耐药鲍曼不动杆菌的基因同源性及耐药机制，为广泛耐药鲍曼不动杆菌感染的防治提供依据。方法采用肠杆菌科基因间重复序列聚合酶链反应（ERIC-PCR）对临床分离的28株广泛耐药鲍曼不动杆菌进行分子生物学分型，采用 PCR 方法检测9种常见β内酰胺酶基因：blaKPC、blaIMP、blaVIM、blaNDM-1、blaOXA-23、blaOXA-24、blaOXA-48、blaOXA-51和 blaOXA-58；膜孔蛋白基因 CarO；插入序列 ISAba1；以及 ISAba1-OXA23、ISAba1-OXA58的连锁检测。结果28株临床分离的广泛耐药鲍曼不动杆菌大多来自危重患者呼吸道标本，ERIC-PCR 基因分型提示为同一来源克隆株；所有菌株均携带 blaOXA-23、blaOXA-51基因，未检测出 B 类β内酰胺酶基因，以及 blaOXA-24、blaOXA-48、blaOXA-58等基因；膜孔蛋白基因 CarO 和插入序列 ISAba 1检测均为阳性，ISAba1-OXA23、ISAba1-OXA58连锁检测均未扩增到预期条带。结论研究期间临床分离广泛耐药鲍曼不动杆菌为同一克隆株，且携带相同耐药基因，提示存在克隆传播。
目的：瞭解上海市同仁醫院臨床分離廣汎耐藥鮑曼不動桿菌的基因同源性及耐藥機製，為廣汎耐藥鮑曼不動桿菌感染的防治提供依據。方法採用腸桿菌科基因間重複序列聚閤酶鏈反應（ERIC-PCR）對臨床分離的28株廣汎耐藥鮑曼不動桿菌進行分子生物學分型，採用 PCR 方法檢測9種常見β內酰胺酶基因：blaKPC、blaIMP、blaVIM、blaNDM-1、blaOXA-23、blaOXA-24、blaOXA-48、blaOXA-51和 blaOXA-58；膜孔蛋白基因 CarO；插入序列 ISAba1；以及 ISAba1-OXA23、ISAba1-OXA58的連鎖檢測。結果28株臨床分離的廣汎耐藥鮑曼不動桿菌大多來自危重患者呼吸道標本，ERIC-PCR 基因分型提示為同一來源剋隆株；所有菌株均攜帶 blaOXA-23、blaOXA-51基因，未檢測齣 B 類β內酰胺酶基因，以及 blaOXA-24、blaOXA-48、blaOXA-58等基因；膜孔蛋白基因 CarO 和插入序列 ISAba 1檢測均為暘性，ISAba1-OXA23、ISAba1-OXA58連鎖檢測均未擴增到預期條帶。結論研究期間臨床分離廣汎耐藥鮑曼不動桿菌為同一剋隆株，且攜帶相同耐藥基因，提示存在剋隆傳播。
목적：료해상해시동인의원림상분리엄범내약포만불동간균적기인동원성급내약궤제，위엄범내약포만불동간균감염적방치제공의거。방법채용장간균과기인간중복서렬취합매련반응（ERIC-PCR）대림상분리적28주엄범내약포만불동간균진행분자생물학분형，채용 PCR 방법검측9충상견β내선알매기인：blaKPC、blaIMP、blaVIM、blaNDM-1、blaOXA-23、blaOXA-24、blaOXA-48、blaOXA-51화 blaOXA-58；막공단백기인 CarO；삽입서렬 ISAba1；이급 ISAba1-OXA23、ISAba1-OXA58적련쇄검측。결과28주림상분리적엄범내약포만불동간균대다래자위중환자호흡도표본，ERIC-PCR 기인분형제시위동일래원극륭주；소유균주균휴대 blaOXA-23、blaOXA-51기인，미검측출 B 류β내선알매기인，이급 blaOXA-24、blaOXA-48、blaOXA-58등기인；막공단백기인 CarO 화삽입서렬 ISAba 1검측균위양성，ISAba1-OXA23、ISAba1-OXA58련쇄검측균미확증도예기조대。결론연구기간림상분리엄범내약포만불동간균위동일극륭주，차휴대상동내약기인，제시존재극륭전파。
Objective To investigate the genetic homology in clinical isolates of extensively drug-resistant Acinetobacter baumannii (XDRAB),so as to provide evidence for better controlling hospital infections.Methods The genotypes of 28 clinical XDRAB isolates were determined by Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR).PCR was conducted to analyze 9 types of β-lactamase genes (blaKPC,blaIMP,blaVIM,blaNDM-1,blaOXA-23,blaOXA-24,blaOXA-48, blaOXA-51 and blaOXA-58),the outer membrane porin gene (CarO)and insertion sequence (IS)ISAba1.We also carried out linkage analysis for ISAba1-OXA23 and ISAba1-OXA58.Results Most of the above 28 XDRAB strains were isolated from respiratory tract specimens from intensive care patients.The result of ERIC-PCR showed that there was high homology between all the strains,suggesting that they might derive from the same clone.The genes blaOXA-23,blaOXA-51,CarO and the IS ISAba1 except Class Bβ-lactamase genes,blaOXA-24,blaOXA-48,blaOXA-58,ISAba1-OXA23 and ISAba1-OXA58 were detected in all the clinical strains by PCR.Conclusions All the XDRAB isolates belong to the same clone and carry the same drug-resistant genes,indicating that there was clone spread among XDRAB isolates.
