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目的了解ICU患者感染泛耐药鲍氏不动杆菌携带碳青霉烯酶基因、头孢菌素酶(AmpC酶)基因,从而分析其耐药机制。方法常规细菌培养方法分离细菌,用VITEK-2全自动微生物鉴定/药敏测试系统进行菌种鉴定及体外敏感测定;采用多重PCR检测25株鲍氏不动杆菌携带的碳青霉烯酶、AmpC酶相关耐药基因(16S rRNA、OXA-23、OXA-24、OXA-51、OXA-58、ADC、DHA、ISAba1),并对耐药基因扩增的阳性产物进行DNA序列分析。结果 ICU患者感染泛耐药鲍氏不动杆菌均携带OXA-23、OXA-51、ADC基因,21株携带插入序列ISAba1;DNA序列分析结果显示,OXA-23、OXA-51、ADC分别与NCBI的序列同源性均为99.0%。结论产OXA-23型碳青霉烯酶可能是ICU患者感染鲍氏不动杆菌对碳青霉烯酶类抗菌药物耐药的主要原因,且为同一克隆株传播。
OBJECTIVE: To understand whether ICU patients are infected with Pancreatic Acinetobacter baumannii carrying carbapenemase and cephalosporin (AmpC) genes and analyzing their resistance mechanisms. Methods Bacteria were isolated by conventional bacterial culture method. The strains were identified by VITEK-2 automated microbial identification / susceptibility testing system and the in vitro sensitivities were determined. The PCR products of 25 strains of carbapenemase carrying Acinetobacter baumannii, AmpC (16S rRNA, OXA-23, OXA-24, OXA-51, OXA-58, ADC, DHA and ISAba1). The positive products of resistance gene were analyzed by DNA sequencing. Results The results of DNA sequence analysis showed that OXA-23, OXA-51 and ADC were associated with NCBI The sequence homology was 99.0%. Conclusion OXA-23-producing carbapenemase may be the main cause of resistance to carbapenem-based antimicrobials in Acinetobacter baumannii patients in ICU patients and may be transmitted by the same clone.