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目的分析云浮地区临床科室分离的鲍曼不动杆菌菌株耐药性及产β-内酰胺酶基因型情况,为有效的临床治疗和医院感染控制提供实验室依据。方法采用法国生物梅里埃公司VITEK-2 Compact全自动微生物鉴定仪进行菌株鉴定及药物敏感性试验,并对筛选出的139株多重耐药菌株用聚合酶链反应(PCR)扩增部分基因型,对扩增产物进行基因测序。结果 139株鲍曼不动杆菌对大多数测试药物的耐药率均在80%以上,亚胺培南、哌拉西林/他唑巴坦的耐药率已接近80%,左旋氧氟沙星耐药率相对较低但也已达54.1%;扩增结果显示93株(66.9%)细菌携带Amp C基因,92株(66.2%)携带OXA-23基因,23株(16.5%)携带PER-1型基因,11株(7.9%)携带CTX-M-9型基因,6株(4.3%)携带OXA-58基因,VER-1,CTX-M-1,CTX-M-2,OXA-24均阴性。结论云浮地区临床分离的鲍曼不动杆菌流行株以产Amp C酶株及产OXA-23型碳青霉烯酶株为主且呈多重耐药,应引起临床高度重视,防止医院感染爆发流行。
OBJECTIVE To analyze the drug resistance of Acinetobacter baumannii strains isolated from clinical departments in Yunfu district and the genotypes of β-lactamase producing, so as to provide a laboratory basis for effective clinical treatment and hospital infection control. Methods The strain identification and drug susceptibility test were carried out by VITEK-2 Compact automatic microbial identification instrument of French bioMérieux, and the genotypes were amplified by polymerase chain reaction (PCR) from 139 multi-drug resistant strains. The amplified product was gene sequenced. Results The resistance rates of 139 strains of Acinetobacter baumannii to most of the tested drugs were above 80%, the resistance rate of imipenem and piperacillin / tazobactam was close to 80%, levofloxacin The results showed that 93 (66.9%) bacteria carried Amp C gene, 92 (66.2%) carried OXA-23 gene and 23 (16.5%) carried PER- 1, CTX-M-1, CTX-M-2 and OXA-24 were carried in 11 strains (7.9%) carrying CTX-M- All negative. Conclusion The clinically isolated strains of Acinetobacter baumannii in Yunfu area are mainly AmpC-producing strains and OXA-23-producing carbapenemase strains. They are multidrug-resistant and should be highly regarded clinically to prevent the outbreak of nosocomial infection .