【摘要】 目的研究云南省昆明地区碳青霉烯类耐药鲍曼不动杆菌(CRAB)的耐药性、同源性及碳青霉烯酶基因的携带情况。方法收集2009年10月-2010年10月云南省昆明地区临床分离的碳青霉烯类耐药鲍曼不动杆菌215株。应用改良Hodge试验、EDTA双纸片增效试验筛选产碳青霉烯酶的菌株,PCR扩增分析碳青霉烯酶的基因型,随机扩增多态性技术(RAPD)分析菌株的同源性。结果 215株多重耐药鲍曼不动杆菌中,190株(88.4%)检出OXA-51基因;150株(69.8%)检测出OXA-23基因,其中140株OXA-23表达菌在改良Hodge试验中为阳性;12株(5.6%)检出VIM基因且EDTA协同实验均为阳性。RAPD技术将215株碳青霉烯类耐药鲍曼不动杆菌分为7个基因型,其中A型为主要克隆。结论 OXA-23和OXA-51是本地区碳青霉烯类耐药鲍曼不动杆菌的主要基因型,已出现VIM型碳青霉烯类耐药鲍曼不动杆菌,且多重耐药鲍曼不动杆菌存在院内感染的现象。更多还原

【Abstract】 Objective To study the drug resistance,homology of CRAB and the carrying status of carbapenemase gene in Kunming area,Yunnan province. Methods A total of 215 clinical isolated strains of carbapenem-resistant Acinetobacter baumannii were collected from Kunming,Yunnan province from October 2009 to October 2010. Modified Hodge test and EDTA double pieces efficiency method were used to screen strains producing carbapenemases. Genotypes of carbapenamases were determined by polymerase chain reaction( PCR). The homology of carbapenem-resistant Acinetobacter baumannii was detected by randomly amplified polymorphism DNA( PARD). Results Among 215 carbapenem-resistant Acinetobacter baumannii strains,OXA-51 gene was positive in 190 strains( 88. 4%),and OXA-23 gene was positive in 150 strains( 69. 8%). Only 140 strains with OXA-23 gene were observed positive modified Hodge test. There were 12 strains( 5. 6%) of carbapenem-resistant Acinetobacter baumannii not only expressed VIM gene but also detected with positive EDTA double pieces efficiency. All of 215 carbapenem-resistant acinctobacter baumannii strains were identified into 7 epidemic subtypes by RAPD technology and subtype A was the most popular clone. Conclusion OXA-23 and OXA-51 genes were the main carbapenemases coding genes of carbapenem-resistant Acinetobacter baumannii. Acinetobacter baumannii with VIM gene were also detected. And nosocomial infection of multiple drug resistant Acinetobacter baumannii had been observed.更多还原