醋酸钙-鲍曼不动杆菌复合菌的分子流行病学及体外药物敏感性分析
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摘要
目的精确鉴定醋酸钙-鲍曼不动杆菌复合菌菌种,了解第三军医大学大坪医院醋酸钙-鲍曼不动杆菌复合菌的菌种分布情况;比较分析各菌种对临床常用抗菌药物的体外敏感率。方法选取2014年2~4月该院临床分离的95株醋酸钙-鲍曼不动杆菌复合菌非重复菌株,采用16SrRNA基因测序法鉴定所有菌株到种;利用VITEK-2Compact自动细菌鉴定药敏仪检测所有细菌对临床常用抗菌药物的体外敏感率。结果95株醋酸钙-鲍曼不动杆菌复合菌精确鉴定为鲍曼不动杆菌81株(85.26%)、皮特不动杆菌10株(10.53%)、医院不动杆菌4株(4.21%)。药敏试验结果显示,鲍曼不动杆菌对三代头孢菌素、氨基糖苷类和碳青霉烯类抗菌药物耐药情况严重,敏感率在20.00%左右。而皮特不动杆菌和医院不动杆菌对常用抗菌药物的敏感率都较高。结论传统的生化鉴定方法在不动杆菌种属鉴定中存在局限性,利用16SrRNA基因测序分析,就可以精确鉴定醋酸钙-鲍曼不动杆菌复合菌,复合菌中各菌种的耐药特性存在较大差异。
Objective To identify strains of Acinetobacter(A.)calcoaceticus-A.baumannii complex accurately,and investigate the species distribution of Acinetobacter calcoaceticus-A.baurnannii(ACB)complex isolated in Daping Hospital.Analysis the antibiotics resistance of ACB complex.Methods A total of 95clinica1 isolates of ACB complex were collected from Daping Hospital from February to April 2014,identify by sequence analysis of 16 SrRNA gene spacer region.Use VITEK-2compact automatic identification of bacteria by susceptibility meter to detect the precise identification of all ACB complex group of drug sensitivity.Results Among all the 95 strains of ACB complex identification results were A.baumanni(81,85.26%),A.pittii(10,10.53%),A.nosocomialis(4,4.21%).A.baumannii to third generation cephalosporins,aminoglycosides and carbapenem antibiotic resistance in serious condition,the sensitive rate was only about 20.00%.But A.pittii and A.nosocomialis had a high sensitivity rate to commonly used antibiotics.Conclusion VITEK-2Compact automatic identification of bacteria susceptibility meter has limitations in identification of Acinetobacter,with analysis of 16 SrRNA gene sequencing,the ACB complex could be accurately identified.There is significant difference in the composite group-resistant characteristics of each species,clinical infection is also various.
Objective To identify strains of Acinetobacter(A.)calcoaceticus-A.baumannii complex accurately,and investigate the species distribution of Acinetobacter calcoaceticus-A.baurnannii(ACB)complex isolated in Daping Hospital.Analysis the antibiotics resistance of ACB complex.Methods A total of 95clinica1 isolates of ACB complex were collected from Daping Hospital from February to April 2014,identify by sequence analysis of 16 SrRNA gene spacer region.Use VITEK-2compact automatic identification of bacteria by susceptibility meter to detect the precise identification of all ACB complex group of drug sensitivity.Results Among all the 95 strains of ACB complex identification results were A.baumanni(81,85.26%),A.pittii(10,10.53%),A.nosocomialis(4,4.21%).A.baumannii to third generation cephalosporins,aminoglycosides and carbapenem antibiotic resistance in serious condition,the sensitive rate was only about 20.00%.But A.pittii and A.nosocomialis had a high sensitivity rate to commonly used antibiotics.Conclusion VITEK-2Compact automatic identification of bacteria susceptibility meter has limitations in identification of Acinetobacter,with analysis of 16 SrRNA gene sequencing,the ACB complex could be accurately identified.There is significant difference in the composite group-resistant characteristics of each species,clinical infection is also various.
引文
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[11]Lee HY,Chen CL,Wang SB,et al.Imipenem heteroresistance induced by imipenem in multidrug-resistant Acinetobacter baumannii:mechanism and clinical implications[J].Inter J Antim Agen,2011,37(4):302-308.
[12]Wen JT,Zhou Y,Yang L,et al.Multidrug-resistant genes of aminoglycoside-modifying enzymes and 16S rRNA methylases in Acinetobacter baumannii strains[J].Genet Mole Res:GMR,2014,13(2):3842-3849.
[13]Chuang YC,Sheng WH,Lauderdale TL,et al.Molecular epidemiology,antimicrobial susceptibilityand carbapenemase resistance determinants among Acinetobacter baumannii clinical isolates in Taiwan[J].J Micro,2014,47(4):324-332.
[2]Jurenaite M,Markuckas A,Suziedeliene E.Identification and characterization of type II toxin-antitoxin systems in the opportunistic pathogen Acinetobacter baumannii[J].J Bacteri,2013,195(14):3165-3172.
[3]Abdalhamid B,Hassan H,Itbaileh A,et al.Characterization of carbapenem-resistant Acinetobacter baumannii clinical isolates in a tertiary care hospital in Saudi Arabia[J].The New Micro,2014,37(1):65-73.
[4]Merino M,Alvarez-Fraga L,Gomez MJ,et al.Complete genome sequence of the multiresistant Acinetobacter baumannii strain AbH12O-A2,isolated during a large outbreak in Spai[J].Genome announcements,2014,193(6):1133-1135.
[5]Chuang YC,Sheng WH,Li SY,et al.Influence of genospecies of Acinetobacter baumannii complex on clinical outcomes of patients with acinetobacter bacteremia[J].Clin Infect Dis,2011,52(4):352-360
[6]Lee NY,Chang TC,Wu CJ,et al.Clinical manifestations,antimicrobial therapy,and prognostic factors of monomicrobial Acinetobacter baumannii complex bacteremia[J].J Infect,2010,61(3):219-227
[7]邹自英,陈莉,刘媛,等.分子生物学方法鉴定鲍曼不动杆菌与仪器鉴定结果比较[J].四川医学,2014,35(9):1123-1125.
[8]Higgins PG,Wisplinghoff H,Krut O,et al.A PCR-based method to differentiate between Acinetobacter baumannii and Acinetobacter genomic species 13TU[J].Clin Microbiol Infect,2007,13(12):1199-1201.
[9]Bartolini A,Frasson I,Cavallaro A,et al.Comparison of phenotypic methods for the detection of carbapenem non-susceptible Enterobacteriaceae[J].Gut pathogens,2014,6(1):13.
[10]凌月明,蔡媛媛,王建福,等.鲍曼不动杆菌临床分布、易感因素及耐药情况分析[J].检验医学与临床,2014,11(2):212-214.
[11]Lee HY,Chen CL,Wang SB,et al.Imipenem heteroresistance induced by imipenem in multidrug-resistant Acinetobacter baumannii:mechanism and clinical implications[J].Inter J Antim Agen,2011,37(4):302-308.
[12]Wen JT,Zhou Y,Yang L,et al.Multidrug-resistant genes of aminoglycoside-modifying enzymes and 16S rRNA methylases in Acinetobacter baumannii strains[J].Genet Mole Res:GMR,2014,13(2):3842-3849.
[13]Chuang YC,Sheng WH,Lauderdale TL,et al.Molecular epidemiology,antimicrobial susceptibilityand carbapenemase resistance determinants among Acinetobacter baumannii clinical isolates in Taiwan[J].J Micro,2014,47(4):324-332.