摘要
目的了解从临床标本中分离到鲍曼不动杆菌的耐药特点和β-内酰胺酶基因类型,为临床治疗和控制院内感染以及流行病学调查提供依据。方法用WalKAway-40对临床分离的141株鲍曼不动杆菌进行鉴定,琼脂稀释法测定14种抗生素的最低抑菌浓度,PCR扩增β-内酰胺酶基因,对blaOXA进行克隆测序分析。结果141株鲍曼不动杆菌对亚胺培南和美罗培南的耐药率最低分别为34.3%和41%,对哌拉西林和头孢曲松的耐药率最高分别为93.3%和89.6%;141株鲍曼不动杆菌中有42株(29.8%)blaOXA-23检测阳性,3株(2.1%)blaOXA-58阳性,83株(58.9%)blaOXA-66阳性,79株(56.0%)TEM基因阳性,3株(2.1%)SHV基因阳性,2株(1.4%)CTX-M-1-like阳性,5株(3.5%)CTX-M-14-like阳性;blaOXA-1、blaOXA-2、blaOXA-10、blaOXA-20、blaOXA-24、blaOXA-48、blaOXA-50、blaOXA-55、blaOXA-60、CTX-M-2、CTX-M-8检测结果均为阴性。结论该临床分离的鲍曼不动杆菌耐药严重,仅对碳青霉烯类、头孢哌酮/舒巴坦保持较高的敏感性;β-内酰胺酶基因型主要是blaOXA-23、blaOXA-66和TEM,这可能与临床上经常使用碳青霉烯类和三代头孢菌素有关。
Objective To investigate the resistance and genotypes of β-lactamases in Acinetobacter baumarmii isolated from clinical specimens, so as to provide a basis for clinical treatment, infection control and epidemiological investigation. Methods WalKAway-40 was used to identify the 141 Acinetobacter baumannii isolated. Minimum inhibitory concentrations（MIC） of fourteen antibiotics were determined by agar dilution method. Main genotypes of betalactamases were assayed by PCR and blaOXA were assayed by TA-cloning and sequencing. Results In these 141 strains,the lowest resistance rates were IMP and MEM,34. 3% and 41% respectively,the highest resistance rates were PIP and CRO,93.3 % and 89.6% respectively ; the positive strains to blaOXA-23, blaOXA-58, blaOXA-66, TEM , SHV, CTX-M-1-likeand CTX-M-14-1ike were 42（29.8%）,3（2.1%）,83（58.9%）,79（56.0%）,3（2.1%）,5 （3.5%） and 2 （ 1.4% ） respectively, blaOXA-1, blaOXA-2, blaOXA-10, blaOXA-20, blaOXA-24, blaOXA-48, blaOXA-50, blaOXA-55, blaOXA-60, CTX-M-2 and CTX-M-8 were not detected in these strains. Conclusion Antimierobial resistance of A. baumannii clinical isolates are severe, only carbapenems and cefoperazone/sulbactam remain good activity against such isolates;the mainβ-lactamase genes are blaOXA-23, blaOXA.66 and TEM, which may be related to commonly use carbopenems and cephalosporin.
出处
《安徽医科大学学报》
CAS
北大核心
2009年第6期755-758,共4页
Acta Universitatis Medicinalis Anhui
作者简介
李春，男，硕士研究生；
王中新，男，副教授，硕士生导师，责任作者，E-mail：aywzhx87@yahoo．com．cn
