天津医药

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天津地区鲍曼不动杆菌16SrRNA甲基化酶基因的检测与耐药性分析

张利娟1,郝邯生2   

  1. 1. 天津医科大学研究生院
    2. 中国人民武装警察部队医学院附属医院
  • 收稿日期:2011-06-03 修回日期:2011-10-28 出版日期:2012-05-15 发布日期:2012-05-15
  • 通讯作者: 张利娟

The Detection of 16SrRNA Methylase Genes in Acinetobacter baumannii Isolates in Tianjin District and the Related Drug Resistance

  • Received:2011-06-03 Revised:2011-10-28 Published:2012-05-15 Online:2012-05-15

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摘要： 摘要：目的 了解天津地区鲍曼不动杆菌16SrRNA甲基化酶基因的携带情况，并进行耐药分析。 方法 收集天津地区2010年8月-2010年12月临床分离的152株鲍曼不动杆菌，采用琼脂稀释法或纸片扩散法测定菌株药敏情况；PCR（聚合酶链反应）对鲍曼不动杆菌扩增7种16SrRNA甲基化酶基因（armA、rmtA、rmtB、rmtC、rmtD、rmtE、npmA）并测序。 结果 152株鲍曼不动杆菌对多粘菌素B的耐药率最低（1.97%）,其次是头孢哌酮/舒巴坦（15.79%）和左氧氟沙星（36.84%），对氨基糖苷类、头孢类和碳青霉烯类等的耐药率高达55%以上。83株耐氨基糖苷类菌株中armA阳性率为87.95%（73/83），占实验菌株的48.03%（73/152），未检出其他6种16SrRNA甲基化酶基因。armA阳性菌株耐药严重，除多粘菌素B外，armA阳性菌株对其余13种抗菌药物的耐药率明显高于armA阴性菌株，差异有统计学意义（P<0.05）。多重耐药和泛耐药占的比例在armA阳性株中（100%和69.86%）也明显高于阴性株（21.52%和11.39%）。 结论 首次报道天津地区鲍曼不动杆菌16SrRNA甲基化酶基因的携带情况。armA广泛存在于鲍曼不动杆菌中，未检出其他6种基因。armA阳性菌株的耐药率、多重和泛耐药率均较高。且armA阳性菌株均为多重耐药株，是否提示armA阳性菌株临床均应按照多重耐药菌选择抗菌药物治疗尚应扩大样本量观察。

关键词: 氨基糖苷类抗菌药物, 鲍曼不动杆菌, 16SrRNA甲基化酶基因

Abstract: Abstract Objective To investigate the prevalence of 16SrRNA methylase genes and the rate of drug resistance in Acinetobacter baumannii isolates in Tianjin District.Methods A total of 152 strains of Acinetobacter baumannii were collected from clinical specimens in Tianjin District from August 1st,2010 to December 31st,2010.The primary antimicrobial susceptibility testing was performed by either Broth dilution or Kirby-Bauer Disk diffusion;Seven 16SrRNA methylase genes (armA、rmtA、rmtB、rmtC、rmtD、rmtE、npmA) were amplified by polymerase chain reaction(PCR) and sequenced.Results Polymyxin resistance rate (1.97%) among 152 strains is the lowest,followed are Cefoperazone/sulbactam(15.79%) and Levofloxacin(36.84%). The resistance rates to Aminoglycoside、Cephalosporin、 Carbapenem are above 55%.73 of the 83 resistance to Aminoglycoside strains were armA genes positive(87.95%).account for 48,03% of all the experimental strains. No rmtA、rmtB、rmtC、rmtD、rmtE、npmA were found.Except the Polymyxin,the rates of resistance to the rest 13 antibiaotics were significantly higher in armA gene positive strains than in armA gene negative strains.(P<0.05).Multidrug-resistance Acinetobacter baumannii (MDRAb) and Pandrug-resistance Acinetobacter baumannii(PDRAb) were also higher in armA gene positive strains (100% and 69.86% respectively) than in armA gene negative strains(21.52% and 11.39% respectively) .Conclusion The rate of 16SrRNA methylase genes (armA) were firstly reported in Tianjin district.armA gene is widely existed in Acinetobacter baumannii strains. No other six genes were found in Acinetobacter baumannii.The rate of drug resistance in armA positive strains were higher than in armA negative ones.The number of MDRAb and PDRAb are significantly larger in armA gene positive strains than in armA negative ones.Also armA positive strains are all MDRAb.Further research was needed to confirm wether the armA gene positive strains can be treated as MDRAb in clinical therapy by collecting more strains.

Key words: Aminoglycoside antibiotics, Acinetobacter baumannii, 16SrRNA methylase genes