论文部分内容阅读
目的了解天津市南开医院临床分离碳青霉烯类耐药鲍曼不动杆菌(CRAB)的流行特征、耐药机制及基因同源性,为CRAB感染的防治提供依据。方法收集38株临床非重复分离的CRAB,进行碳青霉烯酶和金属β-内酰胺酶表型筛选,分析其耐药性、流行特征、耐药机制及基因同源性。结果 38株临床分离的CRAB主要来自痰液标本,ICU分离菌株数最高;米诺环素和替加环素未出现耐药株;碳青霉烯酶表型检测有33株阳性菌株,阳性率为86.8%;未检出产金属β-内酰胺酶菌株;38株CRAB均携带bla_(OXA-23)和bla_(OXA-51)基因,未检出bla_(OXA-24)、bla_(OXA-58)、bla_(KPC)、bla_(GES)、bla_(IMP)、bla_(GIM)、bla_(VIM)和bla_(NDM-1)基因,插入序列ISAba1检测均阳性,ISAba125扩增阳性2株,均未检出插入序列ISAba4;ERIC2-PCR基因分型提示为同一来源克隆株。结论本院分离的CRAB为同一克隆株,且都携带耐药基因bla_(OXA-23)和bla_(OXA-51)及插入序列ISAba1,提示存在克隆传播。
Objective To understand the epidemiological characteristics, drug resistance mechanism and gene homology of clinically isolated carbapenem-resistant Acinetobacter baumannii (CRAB) in Nankai Hospital of Tianjin, and to provide evidence for the prevention and treatment of CRAB infection. Methods 38 noncancerous CRAB isolates were collected and screened for carbapenemase and β-lactamase phenotype. The drug resistance, epidemic characteristics, drug resistance mechanism and gene homology were analyzed. Results The 38 clinical isolates of CRAB mainly came from sputum samples, with the highest number of isolates in ICU, no resistant strains of minocycline and tigecycline, and 33 positive strains of carbapenemase. The positive rate (OXA-23) and bla (OXA-51) genes were not detected in all 38 CRAB strains, bla_ (OXA-24) and bla_ 58), bla_ (KPC), bla_ (GES), bla_ (IMP), bla_ (GIM), bla_VIM and bla_NDM-1. No insert was detected in ISAba4; ERIC2-PCR genotyping suggested that the same origin clone. CONCLUSION: The CRAB isolated from our hospital is the same clonal strain, and both carry the resistance genes bla_ (OXA-23) and bla_ (OXA-51) and the inserted sequence ISAba1, suggesting the presence of cloning.