泛耐药鲍曼不动杆菌β—内酰胺类抗菌药物耐药机制研究(1)
摘要：目的 探讨一组泛耐药鲍氏不动杆菌β-内酰胺类抗菌药物耐药机制。方法 收集2015年1月～6月湖北省黄石市中心医院(A)住院患者中分离的20株泛耐药鲍氏不动杆菌，用mdfA测序确认菌种，再采用聚合酶链反应(PCR)法分析32种β-内酰胺类药物获得性耐药基因、1种膜孔蛋白carO基因、1种获得性外排泵adeB泵蛋白基因。结果 20株泛耐药鲍氏不动杆菌共检出4种β-内酰胺类获得性耐药基因，A类β-内酰胺酶基因TEM、C类β-内酰胺酶基因ADC、D类β-内酰胺酶基因OXA-23、OXA-51，四者阳性率均为100.00%；B类β-内酰胺酶基因未检出；膜孔蛋白carO基因缺失率为100.00%，外排泵adeB基因阳性率为95.00%。结论 泛耐药鲍氏不动杆菌中携带的耐药基因和耐药表型相对应，对β-内酰胺类药物耐药与产TEM、ADC、OXA-23、OXA-51β-内酰胺酶基因，膜孔蛋白carO基因缺失和获得外排泵adeB3种耐药机制有关。
关键词：鲍氏不动杆菌；β-内酰胺酶基因；膜孔蛋白基因；外排泵adeB基因；泛耐药
, 百拇医药
中图分类号：R446.5；R450 文献标识码：A 文章编号：1006-1959(2017)26-0031-04
Abstract：Objective To investigate the drug resistance mechanism of a group of Pan-drug-resistant Acinetobacter baumannii β-lactam antibiotics. Methods 20 strains of Pan-drug-resistant Acinetobacter baumannii isolated from hospitalized patients in central hospital of Huangshi(A) in Hubei province from January to June 2015 were collected.The strains were confirmed by mdfA sequencing，and then polymerase chain reaction(PCR) The results showed that there were 32 β-lactam drug resistance genes， 1 membrane pore protein carO gene and 1 adaptive efflux pump adeB pump gene.Results 20 strains of pan-resistant acinetobacter baumannii were detected four kinds of β-lactam acquired resistance genes，class A β-lactamase gene TEM，C-type β-lactamase gene ADC，D-type β-lactamase gene OXA-23，OXA-51，the four were 100.00% positive rate；The amidase gene was not detected；membrane hole protein carO gene deletion rate was 100.00%，efflux pump adeB gene positive rate was 95.00%.Conclusion The resistance genes and drug resistance phenotypes carried by the drug-resistant acinetobacter baumannii strains correspond to β-lactam drug resistance and the production of TEM，ADC，OXA-23 and OXA-51β-lactamase genes，deletion of membrane pore protein carO gene and efflux pump adeB3 resistance mechanism.
, 百拇医药
Key words：Acinetobacter baumannii；β-lactamase gene；Membrane porin gene；Efflux pump adeB gene；Pan-drug resistance
繼临床分离到多药耐药的鲍氏不动杆菌(MDRAB)后，更严重的泛耐药鲍氏不动杆菌(XDRAB)与全耐药鲍氏不动杆菌(PDRAB)在国内外都有分离报告[1-5]。为全面了解XDRAB β-内酰胺类抗菌药物耐药机制，我们对分离自湖北省黄石市中心医院20株XDRAB进行了13种A类β-内酰胺酶基因、10种B类β-内酰胺酶基因(金属β-内酰胺酶)、2种C类β-内酰胺酶基因(AmpC酶)、8种D类β-内酰胺酶基因和膜孔蛋白carO基因以及外排泵adeB基因检测，现报道如下。
1资料与方法
1.1 一般资料
, 百拇医药 20株XDRAB均分离自2015年1月～6月我院住院患者各种标本鉴定的菌株，每位患者一株菌。
1.2 菌种鉴定和药敏试验
全部XDRAB经鲍氏不动杆菌种特异基因mdfA检测确认。药敏试验采用K-B纸片琼脂扩散法测定菌株对抗菌药物的抑菌环直径。药敏纸片为英国Oxoid公司产品，培养基为法国生物梅里埃公司产品，结果判断按美国临床实验室标准协会(CLSI)2013版执行。
1.3 细菌DNA制备
蛋白酶K水解离心快速裂解法。挑纯培养菌落置0.5 ml离心管内(内预置200 ng/ml蛋白酶K溶液400 μl)，56 ℃水浴2 h，改95 ℃水浴10 min，即为基因检测模板液，-20 ℃冰箱保存。, 百拇医药(鲍群丽 汪宏良 柯俊)
关键词：鲍氏不动杆菌；β-内酰胺酶基因；膜孔蛋白基因；外排泵adeB基因；泛耐药
, 百拇医药
中图分类号：R446.5；R450 文献标识码：A 文章编号：1006-1959(2017)26-0031-04
Abstract：Objective To investigate the drug resistance mechanism of a group of Pan-drug-resistant Acinetobacter baumannii β-lactam antibiotics. Methods 20 strains of Pan-drug-resistant Acinetobacter baumannii isolated from hospitalized patients in central hospital of Huangshi(A) in Hubei province from January to June 2015 were collected.The strains were confirmed by mdfA sequencing，and then polymerase chain reaction(PCR) The results showed that there were 32 β-lactam drug resistance genes， 1 membrane pore protein carO gene and 1 adaptive efflux pump adeB pump gene.Results 20 strains of pan-resistant acinetobacter baumannii were detected four kinds of β-lactam acquired resistance genes，class A β-lactamase gene TEM，C-type β-lactamase gene ADC，D-type β-lactamase gene OXA-23，OXA-51，the four were 100.00% positive rate；The amidase gene was not detected；membrane hole protein carO gene deletion rate was 100.00%，efflux pump adeB gene positive rate was 95.00%.Conclusion The resistance genes and drug resistance phenotypes carried by the drug-resistant acinetobacter baumannii strains correspond to β-lactam drug resistance and the production of TEM，ADC，OXA-23 and OXA-51β-lactamase genes，deletion of membrane pore protein carO gene and efflux pump adeB3 resistance mechanism.
, 百拇医药
Key words：Acinetobacter baumannii；β-lactamase gene；Membrane porin gene；Efflux pump adeB gene；Pan-drug resistance
繼临床分离到多药耐药的鲍氏不动杆菌(MDRAB)后，更严重的泛耐药鲍氏不动杆菌(XDRAB)与全耐药鲍氏不动杆菌(PDRAB)在国内外都有分离报告[1-5]。为全面了解XDRAB β-内酰胺类抗菌药物耐药机制，我们对分离自湖北省黄石市中心医院20株XDRAB进行了13种A类β-内酰胺酶基因、10种B类β-内酰胺酶基因(金属β-内酰胺酶)、2种C类β-内酰胺酶基因(AmpC酶)、8种D类β-内酰胺酶基因和膜孔蛋白carO基因以及外排泵adeB基因检测，现报道如下。
1资料与方法
1.1 一般资料
, 百拇医药 20株XDRAB均分离自2015年1月～6月我院住院患者各种标本鉴定的菌株，每位患者一株菌。
1.2 菌种鉴定和药敏试验
全部XDRAB经鲍氏不动杆菌种特异基因mdfA检测确认。药敏试验采用K-B纸片琼脂扩散法测定菌株对抗菌药物的抑菌环直径。药敏纸片为英国Oxoid公司产品，培养基为法国生物梅里埃公司产品，结果判断按美国临床实验室标准协会(CLSI)2013版执行。
1.3 细菌DNA制备
蛋白酶K水解离心快速裂解法。挑纯培养菌落置0.5 ml离心管内(内预置200 ng/ml蛋白酶K溶液400 μl)，56 ℃水浴2 h，改95 ℃水浴10 min，即为基因检测模板液，-20 ℃冰箱保存。, 百拇医药(鲍群丽 汪宏良 柯俊)