本文選題：耐藥性 + 鮑曼不動桿菌　； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的了解山東省成武縣人民醫(yī)院鮑曼不動桿菌臨床分離菌株的分布特點(diǎn)、耐藥現(xiàn)狀與耐藥譜特征,并檢測鮑曼不動桿菌aba I基因的攜帶情況,分析其陽性攜帶與臨床分離菌株耐藥性的關(guān)系。方法收集2012年10月至2013年10月山東省成武縣人民醫(yī)院分離出的70株鮑曼不動桿菌,采用K-B紙片法檢測菌株的耐藥特點(diǎn),采用PCR技術(shù)擴(kuò)增其生物膜合成相關(guān)基因,檢測鮑曼不動桿菌臨床分離菌株基因攜帶情況。結(jié)果(1)70株鮑曼不動桿菌臨床分離毒株中,有40株(57.14%)為多重耐藥菌株,6株(8.57%)是泛耐藥菌株。(2)鮑曼不動桿菌分離菌株對臨床常用的15種抗菌藥物存在普遍耐藥情況。鮑曼不動桿菌分離菌株耐藥率最低的抗菌藥為亞胺培南和阿米卡星,耐藥率分別為30.00%和32.86%;其次是美羅培南和頭胞吡肟,耐藥率分別是38.57%和41.43%;對頭孢曲松、哌拉西林、頭孢呋辛的耐藥率較高,分別為78.57%和78.57%、85.71%;對其余抗菌藥物的耐藥率均超過50.00%。(3)70株鮑曼不動桿菌中,47株aba I基因陽性,陽性率為67.14%;aba I基因陽性分離菌株的耐藥率明顯高于陰性菌株。(4)70株鮑曼不動桿菌中,52株int I1基因陽性,陽性率為74.29%;int I1基因陽性分離菌株的耐藥率明顯高于陰性菌株。(5)70株鮑曼不動桿菌中,csu C,csu D,csu E基因檢出率分別為70.00%,78.57%和72.86%,基因陽性分離菌株對15種抗菌藥物的耐藥率大多高于陰性菌株,但多無統(tǒng)計學(xué)意義。結(jié)論(1)鮑曼不動桿菌臨床分離菌株耐藥率較高,其中對亞胺培南、阿米卡星以及美羅培南和頭胞吡肟的耐藥率較低,可作為治療鮑曼不動桿菌感染的選擇用藥。(2)鮑曼不動桿菌主要感染部位為呼吸道,主要分布科室為重癥醫(yī)學(xué)科和呼吸科。(3)鮑曼不動桿菌臨床分離菌株生物膜相關(guān)基因aba I和int I1檢出率高,其在鮑曼不動桿菌多重耐藥機(jī)制中起重要作用。
[Abstract]:Objective to investigate the distribution characteristics of Acinetobacter baumannii clinical isolates in Chengwu County people's Hospital of Shandong Province, the present situation of drug resistance and the characteristics of drug resistance spectrum, and to detect the carrying of Acinetobacter baumannii aba I gene. To analyze the relationship between its positive carrying and drug resistance of clinical isolates. Methods from October 2012 to October 2013, 70 strains of Acinetobacter baumannii isolated from people's Hospital of Chengwu County, Shandong Province were collected. K-B disk method was used to detect the drug resistance of the strain, and PCR was used to amplify the genes related to biofilm synthesis. To detect the gene carriers of Acinetobacter baumannii clinical isolates. Results of the 70 clinical isolates of Acinetobacter baumannii, 40 strains (57.14) were multidrug resistant strains (6 strains, 8.57%) were pan-resistant strains. (2) Acinetobacter baumannii isolates showed universal resistance to 15 kinds of antimicrobial agents commonly used in clinic. The antimicrobial resistance rates of Acinetobacter baumannii isolates were imipenem and amikacin, which were 30.00% and 32.86 respectively, followed by meropenem and cephalpyridoxime, with resistance rates of 38.57% and 41.43%, respectively, for ceftriaxone, piperacillin, ceftriaxone and piperacillin. The drug resistance rate of cefuroxime was 78.57% and 78.57%, respectively, and the resistance rate to other antimicrobial agents was higher than that of 50.00.30.The aba I gene of 47 strains of Acinetobacter baumannii was positive, and the resistance rate of cefuroxime was 78.57% and 85.71%, respectively. The positive rate of int I1 gene was significantly higher in the positive strains 67.14A than in the negative strains. 52 strains of Acinetobacter baumannii strains were positive for the int I1 gene, and the positive rate was higher than that of the negative strains of Acinetobacter baumannii. The positive rate was 74.29% and 72.86%, respectively. The rate of drug resistance of positive isolates was significantly higher than that of Acinetobacter baumannii (70.0078.57%) and positive isolates (72.86%), respectively. The resistance rate of positive isolates to 15 antimicrobial agents was higher than that of Acinetobacter baumannii strains. More than negative strains, But there is no statistical significance. Conclusion the drug resistance rate of Acinetobacter baumannii clinical isolates is high, and the resistance to imipenem, amikacin, meropenem and cephalopime is lower. Acinetobacter baumannii can be used as an alternative drug for treatment of Acinetobacter baumannii infection. The main infection site of Acinetobacter baumannii is respiratory tract. The detection rate of biofilm-associated genes aba I and int I1 in Acinetobacter baumannii clinical isolates was high, which played an important role in the mechanism of multidrug resistance of Acinetobacter baumannii.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R446.5

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