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目的分析烧伤患者感染产超广谱β-内酰胺酶(ESBLs)鲍曼不动杆菌的耐药特性及其耐药基因类型。方法采用纸片扩散法(KB法)测定分离自烧伤患者临床标本的137株鲍曼不动杆菌中产ESBLs菌株对β-内酰胺类抗生素的耐药特征,应用聚合酶链反应(PCR)进行细菌的ESBLs基因分型。结果 37株鲍曼不动杆菌对β-内酰胺类抗生素呈不同程度的耐药。检出产ESBLs菌84株,占61.31%。产ESBLs菌株对哌拉西林、替卡西林、氨苄西林/舒巴坦、头孢噻肟、头孢曲松、头孢他啶、头孢吡肟、氨曲南的耐药率分别为83.33%、88.10%、96.43%、89.29%、85.42%、86.90%、77.38%和89.29%,与非产ESBLs菌株耐药率50.94%~77.36%比较差异有统计学意义(P<0.05);30株产ESBLs菌株中,仅携带TEM、SHV、OXA-23及PER型基因的分别有12株(40.00%)、4株(13.33%)、7株(23.33%)和2株(6.67%),其余5株中有3株(10.00%)同时携带TEM和OXA-23型两种基因,2株(6.67%)同时携带TEM、OXA-23和PER型3种基因。结论烧伤患者感染的产ESBLs鲍曼不动杆菌具有多重耐药性,耐药基因型包括TEM、SHV、OXA-23和PER型。
Objective To analyze the drug resistance and the type of resistance genes of Acinetobacter baumannii (ESBLs) in patients with burn infection. Methods The drug resistance characteristics of ESBLs producing strains of 137 strains of Acinetobacter baumannii isolated from clinical specimens of burn patients to β-lactam antibiotics were determined by disk diffusion method (KB method). The bacteria were detected by polymerase chain reaction (PCR) ESBLs genotyping. Results 37 strains of Acinetobacter baumannii showed different degrees of resistance to β-lactam antibiotics. 84 strains of ESBLs producing bacteria were detected, accounting for 61.31%. The resistance rate of ESBLs-producing strains to piperacillin, ticarcillin, ampicillin / sulbactam, cefotaxime, ceftriaxone, ceftazidime, cefepime and aztreonam were 83.33%, 88.10% and 96.43% , 89.29%, 85.42%, 86.90%, 77.38% and 89.29%, respectively. There were significant differences in the drug resistance rates between non-ESBLs-producing strains and ESBLs-producing ESBLs strains from 50.94% to 77.36% (P < There were 12 (40.00%), 4 (13.33%), 7 (23.33%) and 2 (6.67%) strains of TEM, SHV, OXA-23 and PER genes respectively, 10.00%) carry both TEM and OXA-23 genes and 2 (6.67%) carry both TEM, OXA-23 and PER genes. Conclusion Acinetobacter baumannii (ESBLs) -bacterium infection in burn patients is multi-drug resistant. The resistant genotypes include TEM, SHV, OXA-23 and PER.