呼和浩特地区耐亚胺培南鲍曼不动杆菌耐药性及OXA基因检测

Detection of antimicrobial resistance and OXA genes in imipenemresistant Acinetobacter baumannii from Hohhot region

摘要:

目的了解呼和浩特地区临床分离耐亚胺培南鲍曼不动杆菌（IRAB）的耐药性和OXA碳青霉烯酶基因携带情况，为预防和控制多重耐药鲍曼不动杆菌医院感染提供依据。方法收集2012年1—12月3所呼和浩特三级甲等医院患者临床分离的非重复IRAB 49株， 采用纸片扩散法进行药敏试验，应用聚合酶链反应（PCR）检测4种OXA碳青霉烯酶基因（blaOXA51like、blaOXA23like、blaOXA24like、blaOXA58like)的携带情况。结果49株IRAB对米诺环素的耐药率（8.16%）较低，对其他抗菌药物均具有较高的耐药率（81.63%～100.00%）。 49株IRAB 均携带blaOXA51like基因（检出率为100.00%），其中42株同时携带blaOXA23like基因（检出率为85.71%）;3所医院均检出blaOXA23like、blaOXA51like基因，均未检出blaOXA24like、blaOXA58like。结论IRAB呈多重耐药现象，对米诺环素耐药率最低；该地区IRAB的主要耐药机制是产OXA23型碳青霉烯酶。

关键词:

鲍曼不动杆菌; 抗药性，微生物; 耐碳青霉烯酶; OXA基因; 合理用药

Abstract:

ObjectiveTo realize antimicrobial resistance and carrying status of  OXA carbapenemase among imipenemresistant Acinetobacter baumannii （IRAB）isolated from patients of Hohhot, so as to provide guidance for the prevention and control of healthcareassociated infection(HAI) caused by multidrugresistant Acinetobacter baumannii.  Methods49 IRAB isolates from 3 tertiary firstclass hospitals in Hohhot between January and December 2012 were collected,  antimicrobial susceptibility testing was performed by KirbyBauer disk diffusion method, four genotypes（blaOXA51like,blaOXA23like, bla OXA24like, bla OXA58like )  of  OXA carbapenemase were detected by polymerase chain reaction (PCR). ResultsAll 49 isolated IRAB strains were found to be highly resistant to antimicrobial agents（81.63%100.00%）except to minocycline（8.16%）;  blaOXA51like  was identified in 49 strains（100.00%），42(85.71%）of which also carried blaOXA23like gene ，blaOXA23lik and blaOXA51like were both found in three hospital, bla OXA24like and  bla OXA58like  weren’t found. ConclusionIRAB strains present multidrug resistance, resistant to minocycline is the lowest;  blaOXA23like is the main drugresistance mechanism of IRAB in Hohhot.

Key words:

［Key words］Acinetobcter baumannii; drug resistance, microbial; carbapenemase; OXA gene; rational drug use