Carvalho Karyne Rangel, Carvalho-Assef Ana Paula D'Alincourt, Peirano Gisele, Santos Lia Cristina Galvão Dos, Pereira Maria José Felix, Asensi Marise Dutra
Instituto Oswaldo Cruz/FIOCRUZ, Av. Brasil 4365, Manguinhos, Rio de Janeiro, CEP: 21040-360, RJ, Brazil.
Int J Antimicrob Agents. 2009 Jul;34(1):25-8. doi: 10.1016/j.ijantimicag.2008.12.009. Epub 2009 Feb 11.
The present study reports the dissemination of multidrug-resistant (MDR) OXA-23-producing Acinetobacter baumannii clones throughout hospitals in Rio de Janeiro, Brazil. A total of 110 imipenem-resistant A. baumannii isolates were obtained from January 2006 to September 2007 in eight hospitals. The modified Hodge test was performed to screen for carbapenemase production. Polymerase chain reaction (PCR) and DNA sequencing were performed for the detection of bla(IMP), bla(VIM), bla(OXA-23-like), bla(OXA-24-like), bla(OXA-58) and the class 1 integron. Isolates were typed by pulsed-field gel electrophoresis (PFGE) following digestion with ApaI. All the isolates were MDR and 96 (87.3%) produced the carbapenemase OXA-23. No isolates produced OXA-24, OXA-58 or the metallo-beta-lactamases IMP and VIM. The class 1 integron was absent in all isolates. The A. baumannii isolates were separated into five genotypes, with the highest prevalence of genotype A (71.8%) followed by genotype B (22.7%). Genotype A was present in seven hospitals, whilst genotype B had spread in five hospitals. The OXA-23-producing isolates belonged to all genotypes. The presence of MDR OXA-23-producing A. baumannii in different hospitals in Rio de Janeiro emphasises the need to control the use of carbapenems and to prevent the spread of these organisms in Rio de Janeiro.
本研究报告了产多重耐药（MDR）OXA-23的鲍曼不动杆菌克隆株在巴西里约热内卢各医院的传播情况。2006年1月至2007年9月期间，从里约热内卢八家医院共获得了110株对亚胺培南耐药的鲍曼不动杆菌分离株。采用改良Hodge试验筛选碳青霉烯酶的产生情况。进行聚合酶链反应（PCR）和DNA测序以检测bla(IMP)、bla(VIM)、bla(OXA-23-like)、bla(OXA-24-like)、bla(OXA-58)和1类整合子。用ApaI酶切后，通过脉冲场凝胶电泳（PFGE）对分离株进行分型。所有分离株均为多重耐药，96株（87.3%）产生碳青霉烯酶OXA-23。没有分离株产生OXA-24、OXA-58或金属β-内酰胺酶IMP和VIM。所有分离株均未检测到1类整合子。鲍曼不动杆菌分离株分为五种基因型，其中基因型A的患病率最高（71.8%），其次是基因型B（22.7%）。基因型A存在于七家医院，而基因型B在五家医院传播。产OXA-23的分离株属于所有基因型。里约热内卢不同医院中存在产多重耐药OXA-23的鲍曼不动杆菌，这凸显了在里约热内卢控制碳青霉烯类药物使用并防止这些细菌传播的必要性。
