摘要
目的了解三甲医院携带碳青霉烯酶基因blaOXA-58的鲍曼不动杆菌的检出率和菌株克隆相关性,为临床合理使用抗菌药物和制定恰当的感染控制措施提供理论依据。方法收集四川大学华西医院非重复鲍曼不动杆菌临床分离株。菌种的鉴定通过recA基因测序鉴定。PCR检测菌株的固有碳青霉烯酶基因blaOXA-51/66和获得性碳青霉烯酶基因blaOXA-58。用肠杆菌科基因间重复序列-聚合酶链反应分型技术(ERIC-PCR)、多位点序列分型技术(MLST)和脉冲场凝胶电泳分型技术(PFGE)对blaOXA-58阳性的菌株进行克隆相关性分析。结果经recA和blaOXA-51/66检测证实有115株鲍曼不动杆菌临床分离株。其中,9株对亚胺培南敏感性下降〔最小抑菌浓度(MIC)≥2mg/L〕的菌株携带有blaOXA-58,占7.8%。其ERIC-PCR指纹图谱相似。MLST分型结果显示有8株菌属于ST-95型,1株菌属于ST-75型。8株ST-95型鲍曼不动杆菌的PFGE图谱显示为同一个克隆,分属于两个差异很小的亚型。结论我院部分对碳青霉烯敏感性下降的鲍曼不动杆菌临床分离株携带有获得性碳青霉烯酶基因blaOXA-58。blaOXA-58阳性的鲍曼不动杆菌在我院主要以克隆性播散为主。
Objecitve To investigate the clonal relatedness of local blaoxA-58-carrying Acinetobacter baumannii clinical isolates. Methods Non-duplicated isolates of Acinetobacter baumannii were collected in West China Hospital and verified by recA sequencing. Acquired blaoxA-58 gene and natural blaoxn-51/66 genes were detected by PCR. Strain typing for blaoxA-58-carrying Acinetobacter baurnannii isolates was performed by Enterobacterial repetitive intergenic consensus polymerase chain reaction （ERIC-PCR）, muhilocus sequence typing （MLST） and pulsed-field gel electrophoresis （PFGE）. Results A total of 115 Acinetobacter baumannii isolates were verified by recA gene and blaoxA-5l/66 detection. Among them, nine （7.8%） isolates carry blaoxA-58 with reduced susceptibility to imipenem （MIC ≥2 mg/L） were observed. ERIC-PCR fingerprints of nine blaoxn-58-carrying isolates were highly similar. MLST revealed that eight isolates were ST95 and one isolate was ST75. PFGE showed that eight isolates with the same sequence type were of the same fingerprint types, which were of two closely-related subtypes. Conclusion In West China Hospital, some Acinetobacter baumannii isolates with reduced susceptibility to carbapenem carried blaoxA-58. The major spread way of blaoxA-58-carrying isolates was clonal dissemination.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2013年第3期405-409,共5页
Journal of Sichuan University(Medical Sciences)
基金
国家自然科学基金(No.81101293)资助
