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目的通过研究攀枝花地区临床分离的耐碳青霉烯类鲍曼不动杆菌的耐药性及碳青霉烯酶OXA类型,了解该地区耐碳青霉烯类鲍曼不动杆菌的耐药机制及分子流行病学特征。方法收集2014年1月至2015年5月攀枝花地区两所三甲医院临床分离的127株鲍曼不动杆菌;采用KB法检测21种抗菌药物敏感性,比较碳青霉烯类鲍曼不动杆菌耐药组和敏感组的耐药率;采用聚合酶链反应(PCR)检测OXA基因;最后采用肠杆菌基因间一致重复序列聚合酶链反应(ERIC-PCR)进行分子分型及同源性分析。结果 66株耐碳青霉烯类鲍曼不动杆菌对多黏菌素B、米诺环素、头孢哌酮/舒巴坦的耐药率最低,分别为15.2%、22.7%、24.2%,对其余18种抗菌药物耐药率均高于80.0%,耐药率明显高于敏感组菌株;OXA-23和OXA-51基因的检出率分别为92.4%、98.5%,OXA-24和OXA-58基因未检出;ERIC-PCR分子分型主要可分为A、B、C、D 4个型,以B型为主。结论攀枝花地区耐碳青霉烯类鲍曼不动杆菌耐药非常严重,OXA-23、OXA-51基因为该地区耐碳青霉烯类鲍曼不动杆菌重要基因型,B型为主要流行株。
OBJECTIVE: To investigate the drug resistance of carbapenem-resistant Acinetobacter baumannii isolated in Panzhihua and the type of carbapenemase OXA, to understand the mechanism of resistance to carbapenem-resistant Acinetobacter baumannii And molecular epidemiological characteristics. Methods A total of 127 strains of Acinetobacter baumannii isolated from two top-three hospitals in Panzhihua District from January 2014 to May 2015 were collected. The sensitivity of 21 antimicrobial agents was tested by KB method. Acinetobacter baumannii Resistant group and susceptible group. The OXA gene was detected by polymerase chain reaction (PCR). Finally, molecular typing and homology analysis were performed by Enterobacterial consensus-based repeated sequence polymerase chain reaction (ERIC-PCR) . Results The resistance rates of 66 strains of carbapenem-resistant Acinetobacter baumannii to polymyxin B, minocycline and cefoperazone / sulbactam were 15.2%, 22.7% and 24.2% respectively, The resistance rates of OXA-23 and OXA-51 genes were 92.4% and 98.5%, respectively, while those of OXA-24 and OXA were higher than those of other sensitive strains -58 gene was not detected; ERIC-PCR molecular typing can be divided into A, B, C, D 4 types, mainly B-type. Conclusion The resistance to carbapenem-resistant Acinetobacter baumannii is very serious in Panzhihua. The OXA-23 and OXA-51 genes are the major genotypes of C. carbuncatus resistant to carbapenem in this area. Strain.