摘要
目的探讨某院产PER型超广谱β-内酰胺酶(ESBLs)鲍曼不动杆菌分子流行病学特点及耐药机制。方法选取该院2009年1—5月临床分离的非重复鲍曼不动杆菌129株,采用K-B纸片扩散法进行药敏试验,聚合酶链反应(PCR)扩增PER基因并测序,肠杆菌科基因间重复一致序列(ERIC)-PCR进行同源性分析。结果 78株鲍曼不动杆菌携带PER-1型基因,阳性率60.47%(78/129)。PER-1阳性鲍曼不动杆菌对亚胺培南、美罗培南、氨苄西林/舒巴坦、米诺环素和头孢哌酮/舒巴坦的耐药率分别为46.15%、44.87%、38.46%、10.26%和8.97%,对其余10种抗菌药物的耐药率均>60%;PER-1阳性菌株对头孢他啶、头孢噻肟、头孢吡肟、环丙沙星和左氧氟沙星的耐药率明显高于PER-1阴性菌株(均P<0.05)。78株PER-1阳性菌株包括7型,分别为A型(1株)、B型(1株)、C型(55株)、D型(18株)、E型(1株)、F型(1株)、G型(1株),C和D型为主要克隆型。结论 C和D型PER-1阳性鲍曼不动杆菌为该院最主要的流行株。产PER-1型ESBLs鲍曼不动杆菌呈多重耐药,米诺环素、头孢哌酮/舒巴坦可作为该院鲍曼不动杆菌感染治疗的最佳选药。
Objective To investigate molecular epidemiological characteristics and antimicrobial resistance mecha- nism of PER-type extended-spectrum β-lactamases （ESBLs）-producing Acinetobacter baumannii （A. baumannii）. Methods 129 A. baumannii clinical strains isolated from a hospital between January and May 2009 were performed antimicrobial susceptibility testing by Kirby-Bauer disk diffusion method, PER gene was amplified by polymerase chain reaction （PCR）, PCR amplified products of PER gene were sequenced, genotypes were identified by enterobacterial repetitive intergenic consensus-PCR （ERIC-PCR）. Results PER-1 gene was detected in 78 of 129 clinical iso- lates, positive rate was 60. 47% （78/129）. The resistance rates of PER-l-positive strains to imipenem, meropenem, ampicillin/sulbactam, minocycline and cefoperazone/sulbactam was 46. 15%, 44. 87%, 38. 46%, 10. 26% and 8. 97% respectively,the resistance rates to the other 10 kinds of antimicrobial agents were all〉60%; The resistance rates of PER-l-positive strains to ceftazidime, cefotaxime, cefepime, ciprofloxacin, and levofloxacin were sig- nificantly higher than PER-l-negative strains （all P〈0. 05）. 78 PER-l-positive strains were divided into 7 types, including type A（1）, B（1）, C（55）, D（18）, E（1）, F（1）, and G（1）, of which the main clones were type C and D. Conclusion Type C and D PER-l-positive A. baumannii are the main epidemic strains in this hospital. PER-l-type ESBL-producing A. baumannii strains are multi-drug resistant, minocycline and cefoperazone/sulbactam are optimal antimicrobial agents for treating A. baumannii infection in this hospital.
出处
《中国感染控制杂志》
CAS
2014年第3期129-133,共5页
Chinese Journal of Infection Control
基金
湖南省科技厅基金资助项目(08FJ3175)
关键词
鲍曼不动杆菌
PER-1基因
超广谱Β-内酰胺酶
抗药性
微生物
多重耐药
Acinetobacter baumannii
PER-1 gene
enterobacterial repetitive intergenie consensus-PCR
extend ed-spectrum β-1actamase
drug resistance, microbial
multidrug resistance
