论文部分内容阅读
目的以医院患者感染标本分离的耐碳青霉烯鲍氏不动杆菌(CR-AB)为对象,检测β-内酰胺酶、氨基糖苷类修饰酶、16SrRNA甲基化酶和磺胺耐药酶共15个耐药基因,探讨耐药性与携带耐药基因的相关关系。方法采用PCR扩增技术对2014年1月-2015年5月收集的119株CR-AB菌株进行检测,检测是否携带OXA-23、TEM、SHV、VEB、CARB、DHA、VIM、IMP、PER、aac(3)-Ⅰ、aac(6′)-Ib、aph(3′)-Ⅰ、armA、sul1、sul2基因。结果 119株CR-AB对15种抗菌药物耐药率均>50.0%,基因检出率:TEM 100.0%、OXA-23 95.8%、armA 92.4%、aac(6′)-Ib 19.3%、aac(3)-I 24.37%、aph(3′)-Ⅰ73.11%、sul1 27.73%、sul2 60.50%、SHV2.52%,VEB、CARB、DHA、IMP、VIM、PER未检出。结论本地CR-AB耐β-内酰胺类抗菌药物的机制可能与TEM酶密切相关,但其作用机制受舒巴坦抑制;SHV、VEB、CARB、DHA、IMP、VIM、PER酶可能在本地CR-AB耐β-内酰胺类抗菌药物机制中的作用不大;armA、aph(3′)-Ⅰ可能是本地CR-AB耐氨基糖苷类抗菌药物的重要元件,耐药是多基因联合作用的结果。
OBJECTIVE To determine the levels of β-lactamase, aminoglycoside-modifying enzyme, 16SrRNA methylase and sulfamethoxazole-resistant enzyme in carbapenem-resistant Acinetobacter baumannii isolated from patients with nosocomial infections 15 resistance genes, to explore the relationship between drug resistance and resistance genes. Methods A total of 119 CR-AB strains collected from January 2014 to May 2015 were detected by PCR amplification, and whether OXA-23, TEM, SHV, VEB, CARB, DHA, VIM, IMP, PER, aac (3) -Ⅰ, aac (6 ’) - Ib, aph (3’) - Ⅰ, armA, sul1, sul2. Results The resistance rates of 119 strains of CR-AB to 15 kinds of antibacterials were all above 50.0%. The gene detection rates were 100.0% for TEM, 95.8% for OXA-23, 92.4% for armA, 19.3% for aac (6 ’) - Ib, 3) -I 24.37%, aph (3 ’) - I 73.11%, sul 27.73%, sul 60 60.50%, SHV 2.52%, VEB, CARB, DHA, IMP, VIM and PER were not detected. CONCLUSIONS: The mechanism of local CR-AB resistant β-lactam antibiotics may be closely related to TEM enzyme, but its mechanism of action is inhibited by sulbactam. SHR, VEB, CARB, DHA, IMP, -AB has little effect on the mechanism of β-lactam antibacterial drugs; armA, aph (3 ’) - Ⅰ may be an important element of local CR-AB resistant aminoglycoside antibacterial drugs, and multidrug resistance result.