摘要
目的:分析许昌市中心医院住院患者多重耐药鲍曼不动杆菌(MDR-Ab)耐药性及耐药基因检测结果.方法:选取2021年2 月—2024 年2 月许昌市中心医院住院患者标本中分离出的112 株MDR-Ab,分析MDR-Ab对常见抗菌药物的耐药性及耐药基因检测结果.结果:MDR-Ab对头孢吡肟、头孢他啶、头孢噻肟、环丙沙星的耐药率为100%;对氨苄青霉素舒巴坦、阿米卡星、庆大霉素、左氧氟沙星、四环素、头孢哌酮舒巴坦的耐药率高于80%;对亚胺培南、美罗培南的耐药率高于50%;对米诺环素、替加环素、多粘菌素B1 的耐药率较低,均低于20%.112 株MDR-Ab内检出D类酶耐药基因car O、ade B、OXA-51 基因均为112 株,OXA-23 基因106 株;β-内酰胺酶(A类)耐药基因中TEM 112 株,PER基因29 株;消毒剂耐药基因qac E 60 株;氨基糖苷类耐药基因Arm A 88 株.112 株MDR-Ab均携带多种耐药相关基因,car O、TEM、OXA-51、ade B为100%携带基因;另携带Arm A+OXA-23+qac E基因占比最高(40.07%),其次为携带PER+Arm A+OXA-23+qac E基因(20.54%).结论:MDR-Ab携带多种耐药基因,主要为car O、ade B、OXA-51、TEM基因,对各类抗菌药物的耐药率有差异,临床用药前需加强药敏试验并检测耐药基因.
Abstract
Objective:To investigate multidrug-resistant Acinetobacter baumannii(MDR-Ab)resistance and resistance gene detec-tion in hospitalized patients of Xuchang Central Hospital.Methods:112 strains of MDR-Ab isolated within the specimens of hospital-ized patients of Xuchang Central Hospital from February 2021 to February 2024 were selected to analyze the resistance of MDR-Ab to common antimicrobial drugs and the results of resistance gene detection.Results:The resistance rate of MDR-Ab to ciprofloxacin and cephalosporin antimicrobial drugs was100.00%,to amikacin,ampicillin sulbactam,gentamicin,levofloxacin,tetracycline,cefopera-zone sulbactam was all higher than 80%,to imipenem and meropenem was over 50%,and to tigecycline,polymyxin B1 and minocy-cline was all lower than20%.Within the112 strains of MDR-Ab,D-class enzyme resistance genes were detected,including car O gene(112 strains),ade B gene(112 strains),and OXA-51 gene(112 strains),OXA-23 gene(106 strains),PER gene(29 strains),TEM gene(112 strains)in β-lactamase class A enzyme resistance genes,disinfectant resistance gene qac E(60 strains),and amin-oglycoside resistance gene Arm A(88 strains).No other genotypes were detected.The 112 strains of MDR-Ab were all carrying multi-ple drug-resistant genes,in addition to the genotypes of car O,TEM,OXA-51,and ade B genes(100%),the best proportion carried Arm A+OXA-23+qac E genes(40.07%),followed by those carrying PER+Arm A+OXA-23+qac E genes(20.54%).Con-clusion:The main resistance genes of MDR-Ab are car O gene,ade B gene,OXA-51 gene,and TEM gene,which are severely resist-ant to commonly used antimicrobial drugs in the clinic,and the carrying of multiple resistance genes is an important reason for its re-sistance.It is necessary to strengthen the drug sensitivity test and detect the resistance genes in clinical use of medication so as to guide the rational use of drugs.
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20210677)
维普
万方数据