中国感染控制杂志
中國感染控製雜誌
중국감염공제잡지
CHINESE JOURNAL OF INFECTION CONTROL
2015年
7期
437-442
,共6页
李茜%李庆淑%李智%曲彦%胡丹
李茜%李慶淑%李智%麯彥%鬍丹
리천%리경숙%리지%곡언%호단
鲍曼不动杆菌%碳青霉烯酶%多重耐药%抗药性,微生物%肠杆菌科基因间重复序列-聚合酶链反应%ERIC-PCR
鮑曼不動桿菌%碳青黴烯酶%多重耐藥%抗藥性,微生物%腸桿菌科基因間重複序列-聚閤酶鏈反應%ERIC-PCR
포만불동간균%탄청매희매%다중내약%항약성,미생물%장간균과기인간중복서렬-취합매련반응%ERIC-PCR
Acinetobacter baumannii%carbapenemase%multidrug-resistance%drug resistance,microbial%enterobacterial repetitive intergenic consensus-PCR%ERIC-PCR
目的：了解青岛市两所医院鲍曼不动杆菌（AB ）耐药情况、分布特征，碳青霉烯酶基因携带情况。方法收集两所医院临床分离的145株（A院78株，B院67株）AB进行药敏试验，采用聚合酶链反应（PCR）扩增碳青霉烯酶基因，肠杆菌科基因间一致重复序列（ERIC）-PCR对菌株进行同源性分析。结果 A 院AB对临床常用的16种抗菌药物普遍耐药，对头孢哌酮／舒巴坦耐药率最低（3．85％），其次是米诺环素（16．67％），对其他抗菌药物耐药率均＞73％。B院AB对常用的23种抗菌药物普遍耐药，对米诺环素和替加环素均不耐药，对阿米卡星和左氧氟沙星的耐药率分别为23．88％、38．81％，对其他抗菌药物的耐药率均＞64％。两院所有菌株均携带OXA-51基因，A、B两院碳青霉烯耐药组OXA-23基因的携带率分别为86．76％（59／68），56．67％（34／60），差异有统计学意义（χ2＝14．53，P＜0．001）；A 院3株菌携带OXA-58基因，B 院未检出OXA-58基因。145菌株共分为8个基因型，其中A型71株和E型37株，为主要流行株；A院主要流行A型（46．15％）和E型（41．03％），B院主要流行A型（52．24％）和C型（17．91％）。结论两所医院临床分离的AB耐药情况严重，且存在医院流行，OXA型酶OXA-23、OXA-51基因在介导AB对碳青霉烯类药物耐药中发挥重要作用。
目的：瞭解青島市兩所醫院鮑曼不動桿菌（AB ）耐藥情況、分佈特徵，碳青黴烯酶基因攜帶情況。方法收集兩所醫院臨床分離的145株（A院78株，B院67株）AB進行藥敏試驗，採用聚閤酶鏈反應（PCR）擴增碳青黴烯酶基因，腸桿菌科基因間一緻重複序列（ERIC）-PCR對菌株進行同源性分析。結果 A 院AB對臨床常用的16種抗菌藥物普遍耐藥，對頭孢哌酮／舒巴坦耐藥率最低（3．85％），其次是米諾環素（16．67％），對其他抗菌藥物耐藥率均＞73％。B院AB對常用的23種抗菌藥物普遍耐藥，對米諾環素和替加環素均不耐藥，對阿米卡星和左氧氟沙星的耐藥率分彆為23．88％、38．81％，對其他抗菌藥物的耐藥率均＞64％。兩院所有菌株均攜帶OXA-51基因，A、B兩院碳青黴烯耐藥組OXA-23基因的攜帶率分彆為86．76％（59／68），56．67％（34／60），差異有統計學意義（χ2＝14．53，P＜0．001）；A 院3株菌攜帶OXA-58基因，B 院未檢齣OXA-58基因。145菌株共分為8箇基因型，其中A型71株和E型37株，為主要流行株；A院主要流行A型（46．15％）和E型（41．03％），B院主要流行A型（52．24％）和C型（17．91％）。結論兩所醫院臨床分離的AB耐藥情況嚴重，且存在醫院流行，OXA型酶OXA-23、OXA-51基因在介導AB對碳青黴烯類藥物耐藥中髮揮重要作用。
목적：료해청도시량소의원포만불동간균（AB ）내약정황、분포특정，탄청매희매기인휴대정황。방법수집량소의원림상분리적145주（A원78주，B원67주）AB진행약민시험，채용취합매련반응（PCR）확증탄청매희매기인，장간균과기인간일치중복서렬（ERIC）-PCR대균주진행동원성분석。결과 A 원AB대림상상용적16충항균약물보편내약，대두포고동／서파탄내약솔최저（3．85％），기차시미낙배소（16．67％），대기타항균약물내약솔균＞73％。B원AB대상용적23충항균약물보편내약，대미낙배소화체가배소균불내약，대아미잡성화좌양불사성적내약솔분별위23．88％、38．81％，대기타항균약물적내약솔균＞64％。량원소유균주균휴대OXA-51기인，A、B량원탄청매희내약조OXA-23기인적휴대솔분별위86．76％（59／68），56．67％（34／60），차이유통계학의의（χ2＝14．53，P＜0．001）；A 원3주균휴대OXA-58기인，B 원미검출OXA-58기인。145균주공분위8개기인형，기중A형71주화E형37주，위주요류행주；A원주요류행A형（46．15％）화E형（41．03％），B원주요류행A형（52．24％）화C형（17．91％）。결론량소의원림상분리적AB내약정황엄중，차존재의원류행，OXA형매OXA-23、OXA-51기인재개도AB대탄청매희류약물내약중발휘중요작용。
Objective To investigate antimicrobial resistance,distribution,and carriage of carbapenemase genes of Acinetobacterbaumannii(AB)from two hospitals in Qingdao.Methods 145 AB isolates collected from two hospi-tals (78 from hospital A,67 from hospital B)were performed antimicrobial susceptibility testing,carbapenemase genes were amplified by polymerase chain reaction (PCR);homology analysis were conducted with enterobacterial repetitive intergenic consensus (ERIC)-PCR.Results AB from hospital A were generally resistant to 16 commonly used antimicrobial agents,with the lowest resistant rate of 3.85% to cefoperazone/sulbactam,followed by resist-ance rate of 16.67% to minocycline,resistant rates to the other antimicrobial agents were all>73% . AB from hos-pital B were generally resistant to 23 commonly used antimicrobial agents,but the resistance rates to minocycline and tigecycline were both 0,resistance rates to amikacin and levofloxacin were 23.88% and 38.81% respectively, resistant rates to the other antimicrobial agents were all >64% . All strains carried OXA-5 1 gene,the carriage rates of OXA-23 gene in carbapenem-resistant group were 86.76% (59/68)and 56.67% (34/60)in hospital A and B re-spectively,the difference was significant(χ2= 14.53,P<0.001);OXA-58 gene was detected in 3 isolates in hospi-tal A but not detected from hospital B. 145 AB strains were classified into 8 types,the major prevalence types were type A (n= 71)and E(n= 37);the major prevalence types in hospital A were type A (46.15% )and E(41.03% ), hospital B were type A (52.24% )and C (17.91% ).Conclusion Antimicrobial resistance of clinically isolated AB is serious and prevailed in two hospitals. OXA-23 and OXA-51 genes play an important role in AB resistance to car-bapenems.
