| 周华,杜小聿,杨青,周建英,俞云松,李兰娟.亚胺培南耐药鲍曼不动杆菌碳青霉烯酶和16S rRNA甲基化酶研究[J].Chinese journal of Epidemiology,2009,30(3):269-272 |
| 亚胺培南耐药鲍曼不动杆菌碳青霉烯酶和16S rRNA甲基化酶研究 |
| Study on carbapenemase and 16S rRNA methylase of imipenem-resistant Acinetobacter baumannii |
| Received:September 03, 2008 |
| DOI：10.3760/cma.j.issn.0254-6450.2009.03.017 |
| KeyWord: 鲍曼不动杆菌 脉冲场凝胶电泳 碳青霉烯酶 16S rRNA甲基化酶 |
| English Key Word: Acinetobacter baumannii Pulse-field gel electrophoresis Carbapenemase 16S rRNA methylase?? |
| FundProject:国家自然科学基金资助项t-4(30770116) |
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| Abstract: |
| 目的 研究中国部分地区临床分离亚胺培南耐药鲍曼不动杆菌的碳青霉烯酶基因型及16s rRNA甲基化酶基因. 方法 收集6省市25家医院2004年12月至2005年12月临床分离的342株亚胺培南耐药鲍曼不动杆菌;采用琼脂稀释法和E-test法测定菌株对14种抗菌药物的最低抑菌浓度(MIC);脉冲场凝胶电泳(PFGE)分析亚胺培南耐药菌株同源性;PCR及克隆测序分析碳青霉烯酶基因和16S rRNA甲基化酶基因型. 结果 342株亚胺培南耐药鲍曼不动杆菌对氨苄西林/舒巴坦、头孢哌酮/舒巴坦两个含舒巴坦制剂耐药率分别为68. 0%、54. 2%, 对多粘菌素E耐药率最低为10. 8%, 对米诺环素耐药率75. 9%, 对妥布霉素耐药率87. 4%, 对其他抗菌药物的耐药率均在90%以上;342株亚胺培南耐药鲍曼不动杆菌PFGE分型中303株菌株属于6个广泛流行的克隆株;342株亚胺培南耐药鲍曼不动杆菌中322株携带OXA-23基因, 全部携带OXA-66基因, 314株菌株OXA-23基因上游榆测到插入序列ISAbal, 13株OXA-66基因上游检测到ISAbal;287株对阿米卡星、庆大霉素、妥布霉素、异帕米星、奈替米星全部耐药的菌株巾有221株携带armA型16S rRNA甲基化酶基冈. 结论 OXA-23组D类β-内酰胺酶基因是最主要的碳青霉烯酶基因型, 插入序列ISAbal在介导鲍曼不动杆菌对哑胺培南耐药中起重要作用;16S rRNA甲基化酶基因armA基因在中国哑胺培南耐药鲍曼不动杆菌中分布广泛;克隆播散是亚胺培南耐药鲍曼不动杆菌最主要的传播方式. |
| English Abstract: |
| Objective To investigate the prevalence of 16S rRNA methylases gene in imipenem-resistant Acinetobacter baumannii isolates from China. Methods A total of 342 imipenem-resistant A. baumannii isolates were collected between December 2004 and December 2005, from 25 hospitals of China. Agar dilution was used to determinate the minimal inhibitory concentration(MIC)of these isolates. The homology of these isolates was analyzed by pulse-field gel electrophoresis(PFGE). Several 16S rRNA methylase genes and carbapenemase genes were detected by PCR-based assays and PCR products were sequenced. Results The rates of resistance to ampicillin-sulbactam, cefoperazone-sulbactam, tobramycin, and minocycline were 68. 0%, 54. 2%, 87. 4%, and 75. 9%, respectively. The rate of resistance to polymyxin E was 10. 8%, the lowest among the tested agents. The rates of resistance to all other tested antimicrobial agents were more than 90%. The A. baumannii isolates belonged to 29 distinct clones. Among them, 6 clones were dominant, consisting of 303 isolates in total. All isolates contained the blaOXA-51-1ike gene(blaOXA-66)and 322 isolates contained the blaOXA-23-1ike gene. PCR with the ISAbal-OXA-23-like primers generated a PCR product in 314 isolates, and PCR with the ISAbal-OXA-51-1ike primers generated a PCR product in 13 strains. 221 armA-positive isolates were identified. Conclusion Most of the imipenem-resistant A. baumannii contained blaOXA-23, with ISAbal upstream of the gene. 16S rRNA methylase gene armA was widely distributed in these isolates. The Results suggested that the spread of clones played an important role in the outbreak of imipenem-resistant A. baumannii in China. |
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