本文關(guān)鍵詞： 鮑曼不動(dòng)桿菌 耐藥性 碳青霉烯酶 超廣譜β內(nèi)酰胺酶 頭孢菌素酶 ISAbal　出處：《浙江大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的： 對浙江省5個(gè)地區(qū)5家醫(yī)院臨床分離的96株不動(dòng)桿菌的耐藥性及主要β內(nèi)酰胺酶分布情況進(jìn)行研究。 方法： 連續(xù)收集我省5個(gè)地區(qū)5家三級醫(yī)院2009年2月起臨床分離非重復(fù)不動(dòng)桿菌共96株。應(yīng)用PCR擴(kuò)增blaOxa-51及16S-23S rRNA序列分析確定不動(dòng)桿菌的基因種型；應(yīng)用紙片擴(kuò)散法測定所有菌株對13種抗菌藥物的敏感性；應(yīng)用瓊脂稀釋法測定多黏菌素B和多黏菌素E的最小抑菌濃度；應(yīng)用PCR擴(kuò)增及測序明確鮑曼不動(dòng)桿菌中主要碳青霉烯酶基因、超廣譜β內(nèi)酰胺酶基因及頭孢菌素酶基因的分布情況。 結(jié)果： 96株不動(dòng)桿菌分別為鮑曼不動(dòng)桿菌(75株)、基因種型3(6株)和基因種型13TU(15株)；鮑曼不動(dòng)桿菌對抗菌藥物的耐藥性要明顯高于其他不動(dòng)桿菌,其中鮑曼不動(dòng)桿菌對亞胺培南和美羅培南的耐藥率均為84.0%,其他不動(dòng)桿菌中未發(fā)現(xiàn)亞胺培南和美羅培南耐藥株；碳青霉烯類抗生素耐藥鮑曼不動(dòng)桿菌對其他抗菌藥物耐藥性強(qiáng)于碳青霉烯類抗生素敏感菌株；OXA-23是鮑曼不動(dòng)桿菌攜帶的最主要碳青霉烯酶基因,且上游存在插入序列ISAbal;多數(shù)頭孢他啶耐藥鮑曼不動(dòng)桿菌blampc上游存在插入序列ISAbal,而頭孢他啶敏感菌株blampc上游未發(fā)現(xiàn)ISAbal. 結(jié)論： 浙江省鮑曼不動(dòng)桿菌耐藥性嚴(yán)重,存在碳青霉烯類抗生素耐藥鮑曼不動(dòng)桿菌在多個(gè)地區(qū)廣泛流行。多種耐藥基因的存在是導(dǎo)致鮑曼不動(dòng)桿菌耐藥的重要原因。
[Abstract]:Objective: Drug resistance of 96 strains of Acinetobacter isolated from 5 hospitals in 5 regions of Zhejiang Province and distribution of major 尾 lactamases were studied. Methods: A total of 96 clinical isolates of Acinetobacter nonrepeated were collected from 5 tertiary hospitals in 5 regions of our province since February 2009. BlaOxa-51 and 16S-23S were amplified by PCR. The gene type of Acinetobacter was determined by rRNA sequence analysis. The susceptibility of all strains to 13 antimicrobial agents was determined by disk diffusion method. The minimal inhibitory concentrations of polymyxin B and polymyxin E were determined by Agar dilution method. The distribution of major carbapenase genes, extended-spectrum 尾 -lactamases and cephalosporinase genes in Acinetobacter baumannii was determined by PCR amplification and sequencing. Results: The 96 strains of Acinetobacter baumannii were 75 strains of Acinetobacter baumannii, 6 strains of gene species type (36 strains) and 15 strains of gene type 13TU. The antibiotic resistance of Acinetobacter baumannii to antimicrobial agents was significantly higher than that of other Acinetobacter baumannii. The resistance rates of Acinetobacter baumannii to imipenem and meropenem were both 84.0%. Imipenem and meropenem resistant strains were not found in other Acinetobacter. Carbapenem antibiotic resistant Acinetobacter baumannii was more resistant to other antimicrobial agents than carbapenem antibiotic sensitive strain. OXA-23 is the most important carbapenase gene carried by Acinetobacter baumannii, and the upstream insertion sequence is ISAbal. Most Ceftazidime resistant Acinetobacter baumannii (blampc) had insert sequence ISAbal. but Ceftazidime sensitive strain blampc did not find ISAbal. Conclusion: Acinetobacter baumannii (Acinetobacter baumannii) has serious drug resistance in Zhejiang province, and carbapenem antibiotic resistant Acinetobacter baumannii is widespread in many areas, and the existence of multiple resistance genes is the important cause of drug resistance of Acinetobacter baumannii.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R378

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