本文關(guān)鍵詞： 鮑氏不動桿菌 β-內(nèi)酰胺類 氨基糖苷類 喹諾酮類 可移動遺傳元件 多耐藥　出處：《中華醫(yī)院感染學(xué)雜志》2016年19期 　論文類型：期刊論文

【摘要】：目的調(diào)查同一病區(qū)分離的多藥耐藥鮑氏不動桿菌耐藥基因狀況及菌株間的親緣關(guān)系。方法收集醫(yī)院2014年1-12月有呼吸道炎癥住院患者痰標(biāo)本中分離的多藥耐藥鮑氏不動桿菌25株,先經(jīng)鮑氏不動桿菌種特異基因PCR檢測確認菌種,再用PCR方法分析11種β-內(nèi)酰胺類耐藥基因、3種β-內(nèi)酰胺類耐藥基因與插入序列連鎖檢測、9種氨基糖苷類耐藥基因、1種喹諾酮類耐藥基因、2種可移動遺傳元件標(biāo)記,再對檢測結(jié)果作樣本聚類分析。結(jié)果 25株多藥耐藥鮑氏不動桿菌每株均檢出β-內(nèi)酰胺類、氨基糖苷類耐藥基因和喹諾酮類藥物作用靶位gyrA基因的突變,共檢出3種β-內(nèi)酰胺類耐藥基因(blaTEM、blaSHV、blaADC),6種氨基糖苷類耐藥基因(armA、aac(3)-Ⅰ、aac(3)-Ⅱ、aac(6′)-Ⅰb、ant(3″)-Ⅰ、ant(2″)-Ⅰ),喹諾酮類藥物作用靶位gyrA基因均存在突變,2種可移動遺傳元件標(biāo)記(intⅠ1、ISaba1);blaADC基因與ISaba1連鎖,連鎖率100.0%;樣本聚類分析顯示,該組菌存在5個克隆傳播,25株可分A與B簇群,A簇群又可分為A-1與A-2亞簇群,A-1亞簇群中1-2-9-10-11號株,A-2亞簇群中3-6-7-14號株與15-17為克隆傳播,B簇群又可分為B-1與B-2亞簇群,B-1亞簇群中5-13-16-19-22-23-24號株與20-21為克隆傳播。結(jié)論多藥耐藥鮑氏不動桿菌菌株聚集現(xiàn)象明顯,5個克隆傳播提示有醫(yī)院感染的存在,將耐藥菌檢測到的耐藥基因陰性與陽性二元結(jié)果作樣本聚類分析進而解析耐藥菌株之間的親緣關(guān)系,對醫(yī)院感染實時監(jiān)測和控制醫(yī)院感染意義重大。
[Abstract]:Objective to investigate the status of multidrug resistance genes of Acinetobacter baumannii isolated from the same area and the relationship between them. Methods the sputum samples of hospitalized patients with respiratory tract inflammation from 2014 to December were collected. Multidrug resistant Acinetobacter baumannii 25 strains. Acinetobacter baumannii species-specific gene PCR was used to identify the strain, and then 11 尾 -lactam resistant genes and three 尾 -lactam resistance genes were detected by PCR method. Nine aminoglycoside resistance genes, one quinolone resistance gene and two transportable genetic element markers. The results were analyzed by cluster analysis. Results 尾-lactams were detected in 25 strains of Acinetobacter baumannii. The mutations of aminoglycoside resistance gene and quinolone target gyrA gene were used to detect three 尾 -lactam resistance genes, namely, blaTEM, blaSHV blaADC. Six aminoglycoside resistant genes, armAcara Aacanus 3HY- 鈪，

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