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2018—2021年某院耐碳青霉烯类鲍曼不动杆菌的耐药性及耐药基因研究

Study on drug resistance and resistance genes of carbapenem-resistant Acinetobacter baumannii in a hospital from 2018 to 2021

摘要目的:探究耐碳青霉烯类鲍曼不动杆菌(CRAb)的耐药性,并分析分离菌株的耐药基因。方法:收集2018年1月至2021年12月郑州大学第五附属医院临床标本中分离的CRAb 339株,以药敏试验检测CRAb对常用抗菌药物的耐药性,聚合酶链式反应(PCR)扩增法检测分离菌株耐药基因携带情况。结果:339株CRAb菌株对阿莫西林/舒巴坦、氨曲南、头孢吡肟、庆大霉素和哌拉西林耐药率最高,对替加环素、多黏素菌B敏感性最高。PCR扩增结果显示,检出的耐药基因以OXA-23(83.14%)、OXA-51(77.01%)、ADC(73.56%)和VIM(15.71%)为主。每株菌株检出1~7种耐药基因,其中检出5种耐药基因的菌株最多,为81株(31.03%)。结论:CRAb菌株的耐药性具有一定特征性,携带的耐药基因以OXA-23、OXA-51、ADC和VIM型为主,临床应加强医院感染防控措施。

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abstractsObjective:To investigate the drug resistance of carbapenem-resistant Acinetobacter baumannii (CRAb), and to analyze the drug resistance genes of the isolated strains.Methods:A total of 339 CRAb strains isolated from clinical specimens in the Fifth Affiliated Hospital of Zhengzhou University from January 2018 to December 2021 were collected. The resistance of CRAb to commonly used antibiotics was detected by drug sensitivity test. The drug resistance genes of isolated strains were detected by ploymerase chain reaction (PCR) amplification method.Results:The 339 CRAb strains had the highest resistance to amoxicillin/sulbactam, aztreonam, cefepime, gentamicin and piperacillin, but had the highest sensitivity to tigecycline and polymyxin B. Results of PCR amplification found that OXA-23 (83.14%), OXA-51 (77.01%), ADC (73.56%) and VIM (15.71%) were main drug resistance genes. One to seven kinds of drug resistance genes were detected in each strain, and strains with 5 kinds of drug resistance genes were the majority (81 strains, 31.03%).Conclusions:There are some characteristics in drug resistance of CRAb strains. OXA-23, OXA-51, ADC and VIM are main drug resistance genes. Prevention and control measures for nosocomial infection should be strengthened in clinical.

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