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目的探讨和分析鲍曼不动杆菌耐药基因及临床抗菌药物的耐药性。方法 74株鲍曼不动杆菌均来源于佛山市第一人民医院收集的临床标本,采用全自动微生物鉴定/药敏测试系统进行药敏试验,利用聚合酶链式反应(PCR)法检测鲍曼不动杆菌携带的耐药相关基因TEM、DHA、OXA-23、OXA-24、PER、IMP、VIM及16s DNA。结果 74株鲍曼不动杆菌对β-内酰胺类药物的耐药性最高,为98.6%~100.0%;对喹诺酮类药物耐药性为73.5%~86.5%;对氨基糖苷类药物耐药性为70.3%~85.1%;对复方新诺明的耐药性为82.4%;对美罗培南/亚胺培南的耐药性最低,为55.4%;74株鲍曼不动杆菌共检出耐药基因5种,检出率由高到低分别为TEM(63.5%)、OXA-23(52.7%)、VIM(17.6%)、PER(9.5%)、OXA-24(2.7%),其中部分鲍曼不动杆菌携带2种或3种耐药基因;41株对美罗培南/亚胺培南耐药的鲍曼不动杆菌的基因扩增结果显示检出4种基因,检出率由高到低依次为OXA-23(68.3%)、TEM(51.2%)、VIM(34.1%)及PER(4.9%)基因,部分对美罗培南/亚胺培南耐药的鲍曼不动杆菌携带2种或3种的耐药基因。结论 TEM、OXA-23、VIM、PER基因是该院鲍曼不动杆菌携带的主要基因型,且部分患者携带了多种耐药基因,OXA-23、VIM及TEM基因与青霉烯类耐药有密切的关联。
Objective To investigate and analyze the drug resistance of Acinetobacter baumannii drug resistance genes and clinical antibacterials. Methods All of the 74 Acinetobacter baumannii strains were collected from clinical specimens collected from Foshan First People’s Hospital. Drug susceptibility tests were performed using an automated microbial identification / susceptibility testing system. Polymerase chain reaction (PCR) Acinetobacter resistant genes TEM, DHA, OXA-23, OXA-24, PER, IMP, VIM and 16s DNA. Results The results showed that 74 strains of Acinetobacter baumannii had the highest resistance to β-lactam, ranging from 98.6% to 100.0%. The resistance to quinolones was 73.5% to 86.5%. The resistance to aminoglycosides Was 70.3% -85.1%, the resistance to cotrimoxazole was 82.4%, the lowest was meropenem / imipenem, which was 55.4%, and 74 strains of Acinetobacter baumannii were detected as resistant (5), the detection rate of which were TEM (63.5%), OXA-23 (52.7%), VIM (17.6%), PER (9.5%) and OXA-24 Acinetobacter baumannii carrying two or three resistance genes; 41 strains of meropenem / imipenem resistant Acinetobacter baumannii gene amplification results showed that the detection of four kinds of genes, the detection rate from high In the order of OXA-23 (68.3%), TEM (51.2%), VIM (34.1%) and PER (4.9%) genes, part of Acinetobacter baumannii resistant to meropenem / Or three kinds of resistance genes. CONCLUSION: TEM, OXA-23, VIM and PER genes are the main genotypes of Acinetobacter baumannii in the hospital, and some patients carry a variety of drug resistance genes. OXA-23, VIM and TEM genes are resistant to penem Drugs are closely related.