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重症监护病房耐碳青霉烯类抗生素鲍曼不动杆菌耐药机制研究 被引量:25

Mechanism of carbapenem resistance in the Acinetobacter baumannii isolates from an intensive care unit
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摘要 目的分析鲍曼不动杆菌碳青霉烯酶基因型,探讨其对碳青霉烯类抗生素耐药率升高的原因。方法收集2008年1月—2012年12月某院重症监护病房(ICU)320株碳青霉烯类抗生素耐药鲍曼不动杆菌。应用VITEK2全自动微生物分析仪进行菌株鉴定与药敏测定,聚合酶链反应(PCR)检测金属β内酰胺酶和OXA碳青霉烯酶基因。WHONET5.4统计软件:分析鲍曼不动杆菌耐药率变化。结果研究期间碳青霉烯类抗生素的耐药率显著增加,鲍曼不动杆菌对美罗培南的耐药率从10.8%升至80.4%,对亚胺培南的耐药率从13.5%升至83.5%。blaOXA-23及ISAba1相关blaOXA-23阳性率均从25.0%升至97.1%。未检测到blaOXA-24和金属β内酰胺酶基因。结论该院ICU鲍曼不动杆菌对碳青霉烯类抗生素的耐药率升高,可能与ISAba1相关blaOXA-23的扩散相关。 Objective To explore the causes of rising carbapenem resistance in Acinetobacter baumannii isolates by analysis of the carbapenemase genotypes in A .baumannii .Methods WHONET 5 .4 was used to analyze the changing resistance profile of A .baumannii isolates over years .A total of 320 carbapenem‐resistant A .baumannii isolates were collected from the patients in an intensive care unit from January 2008 to December 2012 .All strains were identified and tested by VITEK 2 for their susceptibility .The metallo‐β‐lactamases genes and OXA carbapenemase genes were investigated by polymerase chain reaction . Results The resistance rate of A .baumannii isolates to meropenem and imipenem increased rapidly from 10 .8% to 80 .4% and from 13 .5% to 83 .5% during the period from 2008 and 2012 .The prevalence of blaOXA‐23and ISAba1‐associated blaOXA‐23genes increased from 25 .0% to 97 .1% .No metallo‐β‐lactamase encoding genes were detected .Conclusions Our results indicate that the rising carbapenem resistance in the A . baumannii isolates in our intensive care unit may be associated with the high prevalence of blaOXA‐23 and IS A ba1‐associated blaOXA‐23 genes .
出处 《中国感染与化疗杂志》 CAS CSCD 北大核心 2015年第3期253-256,共4页 Chinese Journal of Infection and Chemotherapy
基金 广州市教育局创新团队科研基金(B94117)-广州医院感染对策
关键词 细菌耐药 鲍曼不动杆菌 碳青霉烯酶 antimicrobial resistance A cinetobacter baumannii carbapenemase
作者简介 毛璞(1981-),女,博士,副研究员,主要从事医院感染控制与细菌耐药性研究。 通信作者:黎毅敏,E-mail:dryiminli@vip.163.com。
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