多重耐药鲍曼不动杆菌耐药性及β－内酰胺酶耐药基因的研究

摘要

The carrying situation of the resistance and the resistant genes of β-lactamases in multiple drug resistant Acinetobacter baumannii ( MDR-AB) was studied.The bacterial identification were performed by VITEK 2 compact full-automatic bacterial identification system.Paper diskette diffusion method ( K-B method) was used to detect the drug resistance of A.baumannii to antibiotic drugs.Theβ-lactamase resistance genes were amplified by PCR.The re-sults showed that drug resistance rates of 32 stains of MDR-AB to 13 kinds of commonly used antibiotic drugs were all over 80%.The resistance rates of MDR-AB to imipenem and meropenem were as high as 78.1% and 71.9%, re-spectively, to cefoperazone/sulbactam was 31.3%.Polymyxin B performed the best antibiotic activity, resistance rates was 0%.The resistance genes of extrabroad-spectrum β-lactamases ( ESBLs) and cephalosporinase ( AmpC) were detected, but non metal β-lactamase (MBLs) resistance genes was detected.Of 32 strains of MDR-AB, TEM genes were positive in all strains, 17 strains detected PER gene, 29 strains detected ADC genes.16 strains simultane-ously carry TEM, PER, ADC genes.In conclusion, simultaneously carrying TEM, PER, ADC genes may have been one reason that caused A.baumannii multi-drug resistance.%研究多重耐药鲍曼不动杆菌的耐药性及β－内酰胺酶耐药基因的携带情况。采用VIKET Compact 2全自动细菌鉴定系统进行细菌鉴定，采用纸片扩散法（K－B法）测定鲍曼不动杆菌对抗菌药物的耐药性，应用聚合酶链反应（ PCR）法检测β－内酰胺酶耐药基因。32株多重耐药鲍曼不动杆菌对13种常用抗菌药物的耐药率均＞80％，对亚胺培南和美罗培南耐药率分别高达78．1％和71．9％，头孢哌酮／舒巴坦耐药率31．3％，多粘菌素B抗菌活性最好，耐药率0％。检出超广谱β－内酰胺酶（ ESBLs）和头孢菌素酶（ AmpC）耐药基因，未检出金属β－内酰胺酶（ MBLs）耐药基因。32株多重耐药鲍曼不动杆菌TEM基因均阳性，17株检出PER基因，29株检出ADC基因。有16株菌同时携带TEM、PER、ADC基因。结果表明，同时携带TEM、PER、ADC基因是安徽医科大学解放军174临床学院鲍曼不动杆菌产生多重耐药性的原因之一。