【摘要】： 目的： 檢測碳青霉烯耐藥鮑曼不動桿菌中常見的β-內(nèi)酰胺酶基因。體外誘導鮑曼不動桿菌對多粘菌素B耐藥,研究其耐藥機制。 方法： 收集浙江省8家醫(yī)院和河南省1家醫(yī)院的98株碳青霉烯耐藥鮑曼不動桿菌。采用瓊脂稀釋法和E-test法測定14種抗菌藥物的最小抑菌濃度。脈沖場凝膠電泳(PFGE)分析菌株的同源性。PCR擴增常見的碳青霉烯酶基因。體外誘導鮑曼不動桿菌對多粘菌素B耐藥,探討不動桿菌對多粘菌素B的耐藥機制。 結(jié)果： 98株鮑曼不動桿菌對包括碳青霉烯類在內(nèi)的多種抗生素耐藥,對多粘菌素B全部敏感。替加環(huán)素、阿米卡星和環(huán)丙沙星的耐藥率分別為88.8%、94.4%和97.7%。其余10種抗生素的耐藥率均100%。根據(jù)耐藥表型選取的48株菌株的PFGE條帶相同或相似,為同一克隆株或密切相關(guān)菌株。98株細菌中,94株產(chǎn)OXA-23型碳青霉烯酶,41株產(chǎn)VIM-2型金屬β-內(nèi)酰胺酶,1株產(chǎn)IMP-1型金屬β-內(nèi)酰胺酶,未檢測到IMP-2和VIM-1。鮑曼不動桿菌在體外可被多粘菌素B誘導成耐藥菌株。碳酰氰基對氯苯腙(CCCP)可顯著降低誘導耐藥株多粘菌素B的MIC值。鮑曼不動桿菌誘導前后PmrA-PmrB基因序列完全相同。 結(jié)論： 碳青霉烯耐藥鮑曼不動桿菌中,絕大部分菌株(95.9%,94／98)產(chǎn)OXA-23,將近一半的菌株(41／98)產(chǎn)VIM-2,個別產(chǎn)IMP-1。體外可誘導鮑曼不動桿菌對多粘菌素B耐藥,耐藥原因可能與外排泵的活化有關(guān)。
[Abstract]:Objective: to detect 尾-lactamase gene in acinetobacter baumannii resistant to carbapenem. To study the resistance mechanism of Acinetobacter baumannii to polymyxin B induced in vitro. Methods: 98 strains of carbapenem resistant Acinetobacter baumannii were collected from 8 hospitals in Zhejiang Province and 1 hospital in Henan Province. The minimal inhibitory concentration of 14 antimicrobial agents was determined by Agar dilution method and E-test method. The homology of the strains was analyzed by pulsed field gel electrophoresis (PFGE). The common carbapenase gene was amplified by PCR. The resistance of Acinetobacter baumannii to polymyxin B was induced in vitro, and the mechanism of resistance of Acinetobacter baumannii to polymyxin B was investigated. Results: 98 strains of Acinetobacter baumannii were resistant to many antibiotics including carbapenem and were all sensitive to polymyxin B. The drug resistance rates of tegacycline, amikacin and ciprofloxacin were 88.8% and 97.4%, respectively. The resistance rates of the other 10 antibiotics were 100%. The PFGE bands of 48 strains selected according to the phenotype of drug resistance were the same or similar to those of the same clone or closely related strains. Out of 98 strains, 94 strains produced OXA-23 type carbapenem and 41 strains produced VIM-2 type metal 尾 -lactamases. 1 strain producing IMP-1 type metal 尾 -lactamases, IMP-2 and VIM-1. were not detected Acinetobacter baumannii can be induced into resistant strains by polymyxin B in vitro. Carbyl cyanoyl p-chlorophenylhydrazone (CCCP) significantly decreased the MIC value of polymyxin B in the induced drug resistant strain. The PmrA-PmrB gene sequence of Acinetobacter baumannii was identical before and after induction. Conclusion: in acinetobacter baumannii resistant to carbapenem, most of the strains (95.9% or 94 / 98) produce nearly half of OXA-23, (41 / 98) producing VIM-2, and producing IMP-1. individually. Acinetobacter baumannii resistance to polymyxin B could be induced in vitro.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R378

【引證文獻】

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1 曲俊彥;呂曉菊;;不動桿菌對替加環(huán)素及多黏菌素耐藥機制研究進展[J];中國抗生素雜志;2013年07期

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本文編號：2393587