老年科鲍曼不动杆菌耐药性及外排泵基因研究

Drug resistance and efflux pump gene in Acinetobacter baumannii in department of geriatrics

  • 摘要:
      目的  观察老年科临床分离鲍曼不动杆菌对常用抗菌药物的敏感性及外排泵基因携带情况,为医院感染防控和临床合理用药提供理论依据。
      方法  收集老年科临床分离的非重复鲍曼不动杆菌85株,采用纸片扩散法检测其对临床常用的15种抗菌药物的敏感性,并采用聚合酶链反应(PCR)方法检测adeBadeGadeJ基因的携带情况。
      结果  鲍曼不动杆菌对多黏菌素B的敏感率为100.0%, 对米诺环素(29.4%)、头孢哌酮-舒巴坦(35.3%)、阿米卡星(38.8%)和庆大霉素(41.2%)的耐药率较低,对其他检测药物的耐药率均超过50.0%, 其中多重耐药菌为49株(占57.6%)。PCR结果显示,多重耐药鲍曼不动杆菌adeBadeGadeJ外排泵基因的阳性率分别为73.5%、77.6%和71.4%, 高于非多重耐药鲍曼不动杆菌,差异有统计学意义(P < 0.05)。
      结论  老年科鲍曼不动杆菌耐药形势较严峻,其多重耐药与携带adeBadeGadeJ基因相关。

     

    Abstract:
      Objective  To observe the drug resistance of Acinetobacter baumannii to commonly used antibiotics in department of geriatrics and status of efflux pump gene-carrying so as to provide theoretical basis for prevention and control of nosocomial infection and clinical rational application of drugs.
      Methods  A total of 85 non-repetitive strains of Acinetobacter baumannii were collected and isolated from geriatric patients, disk dilution method was used to determine their drug sensitivity to 15 antibiotics commonly used in clinic. The adeB, adeG and adeJ genes-carrying were tested by polymerase chain reaction(PCR) method.
      Results  The sensitive rate of Acinetobacter baumannii was 100.0% to polymyxin B, 29.4% to minocycline, 35.3% to cefoperazone-sulbactam, 38.8% to amikacin and 41.2% to gentamicin, which had lower sensitive rates. Drug resistance rate of Acinetobacter baumannii to other detected antibiotics was over 50.0%, with 49 strains (57.6%) of multidrug-resistant bacteria. PCR results showed that the positive rates of adeB, adeG and adeJ genes in multi-drug resistant efflux pump gene-carrying Acinetobacter baumannii were 73.5%, 77.6% and 71.4%, respectively, which were significantly higher than those in non-multidrug-resistant bacteria (P < 0.05).
      Conclusion  The drug resistance of Acinetobacter baumannii in geriatrics is serious, and multi-drug resistance is related to carrying adeB, adeG and adeJ genes.

     

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