摘要
目的了解中山市两家医院临床分离的鲍曼不动杆菌的耐药性及耐碳青霉烯类鲍曼不动杆菌(carbapenem-resistant Acinetobacter baumannii,CRAB)耐药基因的携带情况,并分析其同源性,为医院感染控制提供实验室依据。方法收集2018年3—8月中山市两家医院临床分离的35株鲍曼不动杆菌,采用最小抑菌浓度(minimum inhibitory concentration,MIC)法进行16种抗菌药物敏感试验,并筛选出CRAB菌株,采用聚合酶链反应(polymerase chain reaction,PCR)扩增CRAB中的耐药基因并测序确认;应用脉冲场凝胶电泳(pulsed-field gel electrophoresis,PFGE)技术对35株鲍曼不动杆菌进行分子分型。结果35株鲍曼不动杆菌中有33株为CRAB,其余2株对16种抗菌药物全敏感。33株CRAB对替加环素和多粘菌素B均敏感,对米诺环素的敏感率为45.45%,而对其他抗菌药物的耐药率均高达80%以上。33株CRAB均携带OXA-51基因,未检测到IMP和VIM基因。35株鲍曼不动杆菌共分为18个PFGE带型;分为A-F 6个聚类型别,A型(9/35,25.7%)和B型(22/35,62.9%)为主要流行克隆株。结论鲍曼不动杆菌耐药现象严重,携带多种耐药基因可能是鲍曼不动杆菌对碳青霉烯类等多种抗菌药物耐药的重要原因。医院内存在不同克隆株播散以及同一克隆株在医院间流行播散。
Objective To investigate the antibiotic resistance of Acinetobacter baumannii(A.baumannii)and the carriage of resistance genes of carbapenem-resistant Acinetobacter baumannii(CRAB)isolated from two hospitals in Zhongshan city,to analyze their gene homology,and to provide evidence for nosocomial infection control.Methods Thirty-five clinical isolates of A.baumannii were collected from two hospitals in Zhongshan city from March to August 2018.Susceptibilities of the Acinetobacter baumannii isolates to 16 kinds of antibiotics were detected by minimum inhibitory concentration(MIC)method.The resistance genes for the selected CRAB isolates were determined by polymerase chain reaction(PCR)and DNA sequencing.Molecular genotyping was performed for 35 Acinetobacter baumannii isolates by pulsed-field gel electrophoresis(PFGE).Results Thirty-three CRAB isolates were screened from 35 A.baumannii isolates,and the other 2 isolates were sensitive to all the 16 kinds of antibiotics.33 CRAB isolates were sensitive to tigecycline and polymyxin B,and their sensitivity rates to minocycline and other antibiotics were 45.45%and above 80%,respectively.All the 33 CRAB isolates carried OXA-51 gene,but IMP and VIM genes were not detected.18 PFGE types and 6 clusters(A-F)were identified in the 35 A.baumannii isolates.Cluster A(9/35,25.7%)and cluster B(22/35,62.9%)were the main prevalent clones.Conclusions Antibiotic resistance of the A.baumannii isolates in two hospitals in Zhongshan city is serious,and carrying various drug resistance genes may be the important reason for the resistance of A.baumannii to carbapenems and other antibacterial drugs.There are different types of clone isolates scattered in the two hospitals and the same clone isolate prevailed and spread between the two hospitals.
作者
刘绮明
仇绮琳
郑悦康
林金思
吴衍恒
区金结
LIU Qi-ming;QIU Qi-lin;ZHENG Yue-kang;LIN Jin-si;WU Yan-heng;QU Jin-jie(Zhongshan Municipal Center for Disease Control and Prerention,Zhongshan,Guangdong 528403,China)
出处
《实用预防医学》
CAS
2020年第5期580-583,共4页
Practical Preventive Medicine
关键词
鲍曼不动杆菌
耐药基因
脉冲场凝胶电泳
同源性
Acinetobacter baumannii
resistance gene
pulsed-field gel electrophoresis
homology
