周 玉,龚美亮,闫中强,丛玉隆,邓新立.分离自老年病房的鲍曼不动杆菌耐药机制初步研究*[J].现代生物医学进展英文版,2019,19(1):99-103. |
分离自老年病房的鲍曼不动杆菌耐药机制初步研究* |
The Preliminary Research on Resistance Mechanism of Acinetobacter baumannii Prevalent in Geriatric Wards* |
Received:March 08, 2018 Revised:March 28, 2018 |
DOI:10.13241/j.cnki.pmb.2019.01.021 |
中文关键词: 鲍曼不动杆菌 老年患者 耐药基因 |
英文关键词: Acinetobacter baumannii Senile Patients Resistance gene |
基金项目:全军医学科技“十二五”科研项目重点课题(BWS11-C073) |
Author Name | Affiliation | E-mail | ZHOU Yu | Department of Nanlou Clinical Laboratory, PLA general hospital, Beijing, 100853, China | zhouy427@163.com | GONG Mei-liang | Department of Nanlou Clinical Laboratory, PLA general hospital, Beijing, 100854, China | | YAN Zhong-qiang | Department of Nanlou Clinical Laboratory, PLA general hospital, Beijing, 100855, China | | CONG Yu-long | Department of Nanlou Clinical Laboratory, PLA general hospital, Beijing, 100856, China | | DENG Xin-li | Department of Nanlou Clinical Laboratory, PLA general hospital, Beijing, 100857, China | |
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中文摘要: |
摘要 目的:检测老年住院患者分离的鲍曼不动杆菌的主要耐药基因,并研究不同耐药基因型与耐药表型之间的对应关系。方法:用PCR方法检测分离自老年住院患者的不同标本来源的170例非重复鲍曼不动杆菌的耐药基因。检测的耐药基因包括D类碳青霉烯酶:blaOXA-51,blaOXA-23,blaOXA-24,blaOXA-58,B类金属碳青霉烯酶:blaVIM,blaIMP,blaSIM,blaGIM,blaDIM,blaNDM-1,以及A类超广谱β-内酰胺酶:blaKPC,共计11种。根据检测结果对菌株进行基因分型,并研究不同基因型与CRAB和CSAB这两种耐药表型之间的对应关系。结果:170株鲍曼不动杆菌的固有基因blaOXA-51均为阳性,此外,主要检出基因为blaOXA-23,共124株。另外检测出blaKPC 12株,blaOXA-58 6株,blaNDM-13株,blaSIM 2株,blaOXA-24、blaVIM和blaDIM各1株,IMP和GIM未检出。根据检出耐药基因的不同组合,分为blaOXA-51 + blaOXA-23阳性为基础的A型(124株)及blaOXA-23阴性为基础的B型(blaOXA-51,39株)、C型(blaOXA-51 + blaOXA-58,6株)、D型(blaOXA-51 + blaOXA-24,1株)共计四类基因型。从耐药表型来看,128株碳青霉烯耐药菌中有122株blaOXA-23为阳性, 在CRAB中占95.3%(122/128),42株碳青霉烯敏感株中,有40株blaOXA-23为阴性,在CSAB中占95.2%(40/42)。结论:老年病房流行的耐碳青霉烯鲍曼不动杆菌的耐药基因型以blaOXA-23阳性为主。其与鲍曼不动杆菌CRAB耐药表型、blaOXA-23阴性与CSAB耐药表型之间有良好的对应关系。 |
英文摘要: |
ABSTRACT Objective: To detect the major resistance genes of A. baumannii isolated from elderly hospitalized inpatients, and to research the relationship between the resistance genotype and the drug resistant phenotype. Methods: PCR was used to detect the resistance genes of 170 non repetitive AB isolated from different specimens of elderly inpatients, and the resistant genes included the class D carbapenem enzyme: blaOXA-51, blaOXA-23, blaOXA-24, blaOXA-58, class B carbapenem enzyme: blaVIM, blaIMP, blaSIM, blaGIM, blaDIM, blaNDM-1, and type A extended spectrum beta lactamases: blaKPC. Genotyping was applied according to the test results, and the corresponding relationships between different genotypes and phenotypes (including CRAB and CSAB)were investigated. Results: blaOXA-51 was detected in all 170 isolates and blaOXA-23 was detected in 124 isolates. The other test results were as follows: blaKPC (12 strains), blaOXA-58 (6 strains), blaNDM-1 (3 strains), blaSIM (2 strains), blaOXA-24 (1 strains), blaVIM(1 strains) and blaDIM (1 strains), and blaIMP and blaGIM genes were not detected any more. According to the different combination of drug resistance genes, 170 strains were divided into four genotypes: type A was based on blaOXA-51 + blaOXA-23 (124 strains), and others were based on negative of blaOXA-23: type B (blaOXA-51, 39 strains), type C (blaOXA-51 + blaOXA-58, 6 strains), type D (blaOXA-51 + blaOXA-24, 1 strain). In the resistant phenotype, 122 of the 128 carbapenems resistant strains were positive for blaOXA-23, blaOXA-23 positive strains in CRAB accounted for 95.3% (122/128), 40 of 42 carbapenems susceptible strains were negative for blaOXA-23, blaOXA-23 negative strains in CSAB accounted for 95.2% (40/42). Conclusion: The resistant genotypes of carbapenem resistant AB prevalent in geriatric wards were mainly blaOXA-23 positive. There was a good correspondence between blaOXA-23 positive and CRAB phenotype, and correspondingly between blaOXA-23 negative and CSAB phenotype. |
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