耐碳青霉烯鲍曼不动杆菌耐药机制研究及多位点序列分型
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摘要
探究ICU分离的耐碳青霉烯鲍曼不动杆菌(CRAB)耐药机制及其分子流行病学特点。收集ICU患者标本分离的CRAB,VITEK-2 COMPACT、K-B法和E-test法检测药敏,碳青霉烯酶抑制实验(CIM)和PCR检测碳青霉烯酶及其基因,多位点序列分型(MLST)检测同源性。筛选出28株CRAB,对14种抗生素高度耐药。28株含blaOXA-51和blaampC,25株含blaOXA-23,14株含blaTEM基因。MLST得到9种ST型,e BURST得到一个同分型组。ICU病区CRAB耐药性严重,携带blaOXA-23和blaTEM为主,该研究认为ICU鲍曼不动杆菌感染存在流行趋势,需引起高度重视。
To explore the resistance mechanism and molecular epidemiological characteristics of carbapenem-resistant Acinetobacter baumannii( CRAB) isolated from ICU. Collected CRAB strains isolated from patients in an ICU,with VITEK-2 COMPACT. K-B method and E-test method for drug susceptibility test. Carbapenem Inactivation Method was used to detect carbapenemase activity. β-lactamase genes were detected by PCR. Bacterial homology analysis was used by MLST. A total of 28 strains of CRAB were screened out,which were highly resistant to 14 antibiotics. 28 strains all contained blaOXA-51 and blaampC,25 carried the blaOXA-23,and 14 carried the blaTEMgene. The MLST results yielded 9 ST types. The eBURST analysis obtained one group. Carbapenem-resistance of ICU isolated Acinetobacter baumannii is a serious problem. The main drug resistance genes are blaOXA-23 and blaTEM. There is an epidemic trend in Acinetobacter baumannii infection in this ICU,which needs to be highly valued.
To explore the resistance mechanism and molecular epidemiological characteristics of carbapenem-resistant Acinetobacter baumannii( CRAB) isolated from ICU. Collected CRAB strains isolated from patients in an ICU,with VITEK-2 COMPACT. K-B method and E-test method for drug susceptibility test. Carbapenem Inactivation Method was used to detect carbapenemase activity. β-lactamase genes were detected by PCR. Bacterial homology analysis was used by MLST. A total of 28 strains of CRAB were screened out,which were highly resistant to 14 antibiotics. 28 strains all contained blaOXA-51 and blaampC,25 carried the blaOXA-23,and 14 carried the blaTEMgene. The MLST results yielded 9 ST types. The eBURST analysis obtained one group. Carbapenem-resistance of ICU isolated Acinetobacter baumannii is a serious problem. The main drug resistance genes are blaOXA-23 and blaTEM. There is an epidemic trend in Acinetobacter baumannii infection in this ICU,which needs to be highly valued.
引文
[1] Da Silva G J,Domingues S. Insights on the horizontal gene transfer of carbapenemase determinants in the opportunistic pathogen acinetobacter baumannii[J]. Microorganisms,2016,4(3):E29.
[2] Antunes L C,Visca P,Towner K J. Acinetobacter baumannii:evolution of a global pathogen[J]. Pathog Dis,2014,71(3):292-301.
[3] Lee C R,Lee J H,Park M,et al. Biology of Acinetobacter baumannii:pathogenesis,antibiotic resistance mechanisms,and prospective treatment options[J]. Front Cell Infect Microbiol,2017,7:55.
[4]胡付品,郭燕,朱德妹,等. 2016年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2017,17(5):481-91.
[5]胡付品,Hu F P,Guo Y,等. 2005~2014年CHINET中国细菌耐药性监测网5种重要临床分离菌的耐药性变迁[J].中国感染与化疗杂志,2017,17(1):93-9.
[6] van der Zwaluw K,de Haan A,Pluister G N,et al. The carbapenem inactivation method(CIM),a simple and low-cost alternative for the Carba NP test to assess phenotypic carbapenemase activity in gram-negative rods[J]. PLo S One,2015,10(3):e0123690.
[7]符一骐.中国部分地区鲍曼不动杆菌多位点序列分型及碳青霉烯类抗生素耐药机制研究[D].杭州:浙江大学,2012.
[8]张辉,张小江,徐英春,等. 2012年中国CHINET不动杆菌属细菌耐药性监测[J].中国感染与化疗杂志,2014,14(5):392-7.
[9]王涛,王瑞兰.医院获得性鲍曼不动杆菌感染危险因素分析[J].中华肺部疾病杂志(电子版),2015,8(2):200-3.
[10]郭勇,薛杨勇,唐建国.重症监护病房鲍曼不动杆菌感染[J].中国感染与化疗杂志,2014,14(2):172-5.
[11]佘婷婷,沈继录,徐元宏,等.泛耐药鲍曼不动杆菌耐碳青霉烯类抗生素机制研究[J].安徽医科大学学报,2012,47(3):274-8.
[12]王辉,郭萍,孙宏莉,等.碳青霉烯类耐药的不动杆菌分子流行病学及其泛耐药的分子机制[J].中华检验医学杂志,2006,29(12):1066-73.
[13] Bartual S G,Seifert H,Hippler C,et al. Development of a multilocus sequence typing scheme for characterization of clinical isolates[J]. J Clin Microbiol,2005,43(9):4382-90.
[14] Thomas C M,Nielsen K M. Mechanisms of,and barriers to,horizontal gene transfer between bacteria[J]. Nat Rev Microbiol,2005,3(9):711-21.
[15]饶碧华,储新民.某医院黏质沙雷菌碳青霉烯耐药机制及流行病学研究[J].安徽医科大学学报,2018,53(5):745-9.
[2] Antunes L C,Visca P,Towner K J. Acinetobacter baumannii:evolution of a global pathogen[J]. Pathog Dis,2014,71(3):292-301.
[3] Lee C R,Lee J H,Park M,et al. Biology of Acinetobacter baumannii:pathogenesis,antibiotic resistance mechanisms,and prospective treatment options[J]. Front Cell Infect Microbiol,2017,7:55.
[4]胡付品,郭燕,朱德妹,等. 2016年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2017,17(5):481-91.
[5]胡付品,Hu F P,Guo Y,等. 2005~2014年CHINET中国细菌耐药性监测网5种重要临床分离菌的耐药性变迁[J].中国感染与化疗杂志,2017,17(1):93-9.
[6] van der Zwaluw K,de Haan A,Pluister G N,et al. The carbapenem inactivation method(CIM),a simple and low-cost alternative for the Carba NP test to assess phenotypic carbapenemase activity in gram-negative rods[J]. PLo S One,2015,10(3):e0123690.
[7]符一骐.中国部分地区鲍曼不动杆菌多位点序列分型及碳青霉烯类抗生素耐药机制研究[D].杭州:浙江大学,2012.
[8]张辉,张小江,徐英春,等. 2012年中国CHINET不动杆菌属细菌耐药性监测[J].中国感染与化疗杂志,2014,14(5):392-7.
[9]王涛,王瑞兰.医院获得性鲍曼不动杆菌感染危险因素分析[J].中华肺部疾病杂志(电子版),2015,8(2):200-3.
[10]郭勇,薛杨勇,唐建国.重症监护病房鲍曼不动杆菌感染[J].中国感染与化疗杂志,2014,14(2):172-5.
[11]佘婷婷,沈继录,徐元宏,等.泛耐药鲍曼不动杆菌耐碳青霉烯类抗生素机制研究[J].安徽医科大学学报,2012,47(3):274-8.
[12]王辉,郭萍,孙宏莉,等.碳青霉烯类耐药的不动杆菌分子流行病学及其泛耐药的分子机制[J].中华检验医学杂志,2006,29(12):1066-73.
[13] Bartual S G,Seifert H,Hippler C,et al. Development of a multilocus sequence typing scheme for characterization of clinical isolates[J]. J Clin Microbiol,2005,43(9):4382-90.
[14] Thomas C M,Nielsen K M. Mechanisms of,and barriers to,horizontal gene transfer between bacteria[J]. Nat Rev Microbiol,2005,3(9):711-21.
[15]饶碧华,储新民.某医院黏质沙雷菌碳青霉烯耐药机制及流行病学研究[J].安徽医科大学学报,2018,53(5):745-9.