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重症医学科耐碳青霉烯类鲍曼不动杆菌的基因型和同源性分析
张立荣  费樱  江滟
贵州医科大学医学检验学院,贵州贵阳   550025
Genotype and homology analysis of carbapenem-resistant Acinetobacter baumannii in intensive care medicine
ZHANG Lirong   FEI Ying   JIANG Yan
School of Laboratory, Guizhou Medical University, Guizhou Province, Guiyang   550025, China
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摘要 目的 了解贵州省从江县人民医院重症医学科下呼吸道感染患者耐碳青霉烯类鲍曼不动杆菌(CRAB)的基因型,并对部分菌株作同源性分析。 方法 回顾性分析2018年1月至2021年12月贵州省从江县人民医院重症医学科下呼吸道感染患者CRAB占比情况,以分离获得的40株CRAB为研究对象。采用VITEK2-compact全自动细菌鉴定药敏系统作细菌鉴定及药敏。运用PCR技术检测7种常见碳青霉烯酶基因(SHV、TEM、IMP、VIM、ADC、OXA-23、OXA-58)。应用多位点序列分型(MLST)法分析40株试验菌的同源性。 结果 2018—2021年贵州省从江县人民医院重症医学科下呼吸道感染患者CRAB的检出率逐年增加。40株CRAB对多黏菌素敏感率为97.50%,阿米卡星敏感率为80.00%。耐药基因检测发现TEM、ADC、OXA-23基因携带率分别为47.5%、22.5%、22.5%,以及存在多种基因型共同表达的情况。MLST分型结果显示共分为5个序列型,其中以ST195型为主,占62.5%,其次为ST208型,占20.0%。 结论 重症医学科下呼吸道感染患者检出CRAB逐年增加,可选择的抗生素有限。携带TEM、ADC和OXA-23基因是鲍曼不动杆菌对碳青霉烯类药物耐药的主要原因。MLST结果表明ICU病房存在克隆菌株。

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张立荣  费樱  江滟
关键词 碳青霉烯酶鲍曼不动杆菌耐药性耐药基因    
Abstract:Objective To understand the genotypes of carbapenem-resistant Acinetobacter baumannii (CRAB) in patients with lower respiratory tract infection in the Department of Critical Care Medicine, Congjiang County People’s Hospital, Guizhou Province, and perform homology analysis on some strains. Methods A retrospective analysis of the proportion of CRAB in patients with lower respiratory tract infection in the Department of Intensive Care Medicine, Congjiang County People’s Hospital, Guizhou Province from January 2018 to December 2021, with 40 isolated CRAB strains as the research objects. VITEK2-compact automatic bacterial identification drug sensitivity system was used for bacterial identification and drug sensitivity. PCR was used to detect seven common carbapenemase genes (SHV, TEM, IMP, VIM, ADC, OXA-23, OXA-58). Multisite sequence typing (MLST) was used to analyze the homology of 40 strains. Results From 2018 to 2021, the detection rate of CRAB in patients with lower respiratory tract infection in the Department of Intensive Care Medicine of the Congjiang County People’s Hospital increased year by year. The 40 CRAB strains were 97.50% sensitive to Colistin and 80.00% sensitive to Amikacin. The detection of drug resistance genes revealed that the carrying rates of TEM, ADC, and OXA-23 genes were 47.5%, 22.5%, and 22.5%, respectively, as well as the presence of  expression of multiple genotypes. The results of MLST typing showed that there were five sequence types, among which ST195 was the main type, accounting for 62.5%, followed by ST208 type, accounting for 20.0%. Conclusion The detection of CRAB in patients with lower respiratory tract infection in the intensive care unit is increasing year by year, and the choice of antibiotics is limited. Carrying TEM, ADC and OXA-23 genes is the main reason for the resistance of Acinetobacter baumannii to carbapenems. MLST results shows that there are clones in the ICU ward.
Key wordsCarbapenemase    Acinetobacter baumannii    Drug resistance    Drug resistance gene
    
基金资助:贵州省科技计划项目(黔科合平台人才[2019]5610号);
贵州省教育厅创新群体项目(黔教合KY字[2021]016)。
通讯作者: 江滟(1970.2-),女,博士,主任技师,教授;研究方向:微生物的致病机制、临床微生物检验。   
作者简介: 张立荣(1991.8-),女,贵州医科大学医学检验学院2018级临床检验诊断学专业在读硕士研究生;研究方向:微生物的致病机制。
引用本文:   
张立荣  费樱  江滟. 重症医学科耐碳青霉烯类鲍曼不动杆菌的基因型和同源性分析[J]. 中国医药导报, 2023, 20(22): 29-33.
ZHANG Lirong FEI Ying JIANG Yan. Genotype and homology analysis of carbapenem-resistant Acinetobacter baumannii in intensive care medicine. 中国医药导报, 2023, 20(22): 29-33.
链接本文:  
https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.22.06     或     https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I22/29

 

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