【摘要】：目的探討泛耐藥鮑氏不動桿菌獲得性耐藥基因與可移動遺傳、耐藥元件的攜帶及關(guān)聯(lián)性,為臨床治療提供參考依據(jù)。方法收集2014年住院患者中分離的20株泛耐藥鮑氏不動桿菌,用mdfA測序確認菌種,再采用聚合酶鏈反應(yīng)(PCR)及序列分析的方法,分析32種β-內(nèi)酰胺類藥物獲得性耐藥基因,對獲得性耐藥基因與可移動遺傳元件標記測得結(jié)果作指標聚類分析。結(jié)果 20株泛耐藥鮑氏不動桿菌共檢出4種β-內(nèi)酰胺類獲得性耐藥基因、1種膜孔蛋白基因、3種氨基糖苷類獲得性耐藥基因、1種外排泵泵蛋白基因、5種可移動遺傳元件遺傳標記,且陽性率非常高;blaOXA-23群和插入序列ISaba1的連鎖檢測均呈陽性;指標聚類分析提示β-內(nèi)酰胺類獲得性耐藥基因blaTEM、blaADC、blaOXA-23群、blaOXA-51群,氨基糖苷類獲得性耐藥基因aph3′-Ⅰ與可移動遺傳元件中的ISaba1、intⅠ1均高度相關(guān);外排泵泵蛋白基因adeB與IS26高度相關(guān),氨基糖苷類獲得性耐藥基因aac3-Ⅰ與tnpU、tnp513亦高度相關(guān)。結(jié)論泛耐藥鮑氏不動桿菌中攜帶的耐藥基因和耐藥表型相對應(yīng),攜帶blaTEM、blaADC、blaOXA-23群、blaOXA-51群、膜孔蛋白基因carO2缺失、aph3′-Ⅰ及外排泵泵蛋白基因adeB,是泛耐藥鮑氏不動桿菌對β-內(nèi)酰胺類、氨基糖苷類、氟喹諾酮類耐藥的重要原因。
[Abstract]:Objective to investigate the relationship between acquired drug resistance gene of Acinetobacter baumannii and mobile inheritance and drug resistance elements in order to provide reference for clinical treatment. Methods A total of 20 strains of pan-resistant Acinetobacter baumannii isolated from inpatients in 2014 were collected and identified by mdfA sequencing, and 32 尾 -lactam acquired drug resistance genes were analyzed by polymerase chain reaction (PCR) and sequence analysis. The results of acquired drug resistance gene and mobile genetic element markers were analyzed by cluster analysis. Results A total of 4 尾-lactam acquired drug resistance genes, 1 membrane pore protein gene, 3 aminoglycoside acquired drug resistance genes and 1 efflux pump protein gene were detected in 20 strains of pan-resistant Acinetobacter baumannii. 5 kinds of mobile genetic element genetic markers, and the positive rate is very high; The linkage tests of blaOXA-23 group and insertion sequence ISaba1 were positive. Cluster analysis showed that 尾 -lactam acquired drug resistance gene blaTEM,blaADC,blaOXA-23 group, blaOXA-51 group and aminoglycoside acquired drug resistance gene aph3'- 鈪，

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