【摘要】 目的 了解某三级综合医院耐碳青霉烯鲍曼不动杆菌（CRAB）耐药特征和耐药基因情况，确定CRAB的传播类型。方法 收集2021年1月至2022年12月临床分离出的28株CRAB菌株，分别进行药敏试验和全基因组测序，应用CARD基因数据库进行耐药基因分析，使用PubMLST数据库进行多位点序列分型（MLST）分析。结果 28株CRAB菌株感染患者主要分布于重症监护室，标本来源主要为痰液。28株CRAB菌株对大部分药物均表现为高水平耐药，除对米诺环素和甲氧苄啶/磺胺甲口恶唑部分敏感外，仅对多黏菌素B全部中介和对替加环素全部敏感。β-内酰胺酶类耐药基因以bla_OXA-23、bla_OXA-66为主，氨基糖苷类耐药基因以aph（3"）-Ib、aph（6）-Id为主，喹诺酮类耐药基因以gyrA、parC为主，四环素类耐药基因以tetB和tetR为主，磺胺类耐药基因以sul1和sul2为主，多肽类耐药基因为LpsB。MLST结果显示，CRAB的ST分型共有5个，分别为ST540（15株）、ST195（5株）、ST191（4株）、ST229（2株）和ST1968（2株）。结论 耐药基因的携带是CRAB菌株对抗菌药物产生耐药的主要原因之一。该院CRAB均表现为多重耐药，ST分型主要为ST540，其次是ST195。更多还原

【Abstract】 Objective To understand the drug resistance characteristics and drug resistance genes of carbapenem-resistant Acinetobacter baumannii（CRAB） in a tertiary general hospital, and to determine the transmission type of CRAB. Methods A total of 28 CRAB strains isolated clinically from January 2021 to December 2022 were collected for drug sensitivity test and whole genome sequencing, respectively. CARD gene database was used for drug resistance gene analysis, and PubMLST database was used for multilocus sequence typing（MLST） analysis. Results Patients infected with 28 CRAB strains were mainly distributed in the intensive care unit, and the main source of specimens was sputum. The 28 CRAB strains showed high levels of resistance to most drugs. Except for partial sensitivity to minocycline and trimethoprim/sulfamethoxazole, they were only intermediate to polymyxin B and sensitive to tigecycline. The β-lactamase resistance genes were mainly bla_OXA-23and bla_OXA-66, the aminoglycoside resistance genes were mainly aph（3"）-Ib and aph（6）-Id, the quinolones resistance genes were mainly gyrA and parC, the tetracycline resistance genes were mainly tetB and tetR, the sulfonamide resistance genes were mainly sul1 and sul2, and the polypeptide resistance gene was LpsB. MLST results showed that there were 5 ST types of CRAB, including ST540（15 strains）, ST195（5 strains）, ST191（4 strains）, ST229（2 strains） and ST1968（2 strains）. Conclusion The carrying of drug resistance genes is one of the main reasons for the resistance of CRAB strains to antibiotics. CRAB in the hospital showed multiple drug resistance, and the ST type was mainly ST540,followed by ST195.更多还原