CAJ | 학술논문

目的：分析临床多药耐药鲍氏不动杆菌外排泵耐药基因 adeA、adeB、adeC及其调控基因adeR、adeS分布与抗菌药物耐药的关系，为IC U感染鲍氏不动杆菌的同源性有效应对医院感染。方法2012年IC U检出鲍氏不动杆菌102株，采用K‐B法进行药敏试验，PCR测定所有菌株的药物外排泵基因，并利用脉冲场凝胶电泳进行同源性分析。结果94株耐药鲍氏不动杆菌对头孢唑林和呋喃妥因耐药率均为100．0％，对亚胺培南和氨苄西林／舒巴坦的耐药率为75．8％和95．0％，对其他抗菌药物耐药率均＞85．0％；102株鲍氏不动杆菌中 adeA、adeB、adeC、adeR、adeS基因型的阳性株分别为78、79、76、77、74株；5种基因均以阴性为主；敏感株中调控基因 adeR、adeS表达率较低分别为37．5％和25．0％。结论 ICU分离的鲍氏不动杆菌中呈现严重的多药耐药，adeABC外排泵耐药基因相对于敏感株在耐药菌株中大量存在，外排泵基因的高表达与鲍氏不动杆菌的多药耐药存在相关性关系，而且其基因的播散主要通过克隆播散得以传播。
목적：분석림상다약내약포씨불동간균외배빙내약기인 adeA、adeB、adeC급기조공기인adeR、adeS분포여항균약물내약적관계，위IC U감염포씨불동간균적동원성유효응대의원감염。방법2012년IC U검출포씨불동간균102주，채용K‐B법진행약민시험，PCR측정소유균주적약물외배빙기인，병이용맥충장응효전영진행동원성분석。결과94주내약포씨불동간균대두포서림화부남타인내약솔균위100．0％，대아알배남화안변서림／서파탄적내약솔위75．8％화95．0％，대기타항균약물내약솔균＞85．0％；102주포씨불동간균중 adeA、adeB、adeC、adeR、adeS기인형적양성주분별위78、79、76、77、74주；5충기인균이음성위주；민감주중조공기인 adeR、adeS표체솔교저분별위37．5％화25．0％。결론 ICU분리적포씨불동간균중정현엄중적다약내약，adeABC외배빙내약기인상대우민감주재내약균주중대량존재，외배빙기인적고표체여포씨불동간균적다약내약존재상관성관계，이차기기인적파산주요통과극륭파산득이전파。
OBJECTIVE To investigate the distribution of efflux system adeABC coding genes (adeA ,adeB ,adeC) and regulating genes (adeR ,adeS) in multi‐drug resistant A cinetobacter baumannii ,and analyze the relationship between the distribution and the antibiotic resistance so as to effectively deal with nosocomial infections with the homology of A .baumannii in ICU .METHODS Totally 102 A .baumannii isolates were detected from ICU in 2012 ,and their drug susceptibility testing was carried out by Kirby‐Bauer method ,the adeABC efflux pump geno‐types of all isolates were identified by PCR and PFGE was used to conduct homology analysis .RESULTS The re‐sistance rate of ninety‐four isolates of A .baumannii was 100 .0% to cefazolin ,100 .0% to nitrofurantoin ,75 .8%to imipenem ,95 .0% to ampicillin/sulbactam ,and >85 .0% to all other antibacterials .PCR and sequence analysis revealed that there were 78 ,79 ,76 ,77 ,and 74 isolates positive for adeA ,adeB ,adeC ,adeR ,adeS genes of A . baumannii respectively .The five genes were mainly negative .The expressions of regulating genes adeR and adeS were 37 .5% and 25 .0% in sensitive strains .CONCLUSION A .baumannii isolated in ICU has serious multidrug resistance ,adeABC efflux pump genes extensively exist in resistant strains compared to sensitive strains .The high expression of efflux pump genes is correlated to the multidrug resistance of A .baumannii and the spread of these genes is mainly through gene cloning .