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中国三家军队医院耐多药鲍曼不动杆菌的耐药模式和分子流行病学研究。

Susceptibility patterns and molecular epidemiology of multidrug-resistant Acinetobacter baumannii strains from three military hospitals in China.

机构信息

Department of Clinical Microbiology, General Hospital of People's Liberation Army, No. 28 Fu Xing Road, Hai Dian District, Beijing 100853, China.

出版信息

Int J Antimicrob Agents. 2010 Mar;35(3):269-73. doi: 10.1016/j.ijantimicag.2009.10.016. Epub 2009 Dec 29.

Abstract

To date, little has been reported on the susceptibility patterns and molecular characterisation of multidrug-resistant Acinetobacter baumannii (MDRAB) clinical isolates from different Chinese military hospitals. In this study, 49 MDRAB strains were collected from three military hospitals during 2007. The minimum inhibitory concentrations (MICs) of 13 antibiotics were determined for each strain. Genotyping and dendrogram analysis of MDRAB strains were performed using the repetitive sequence-based polymerase chain reaction (rep-PCR) DiversiLab Microbial Typing System. PCR screening was carried out to investigate the distribution of various genes contributing to each resistance phenotype in the main clonal types. The rates of resistance to the majority of antibiotics tested varied between 75.5% and 100%, with the exception of polymyxin B. Two DiversiLab rep-PCR clones (A and B) were widespread in three hospitals in different cities, one clone (D) existed only in two hospitals located in the same city (Beijing), and the other two clones (C and E) were present in only one hospital. In addition, this study shows a high distribution of intI1, ISAba1, bla(OXA-23), bla(ADC), adeB, adeJ, abeM and tet(B) genes, which mediate resistance to structurally unrelated antimicrobials in MDRAB isolates. These results suggest that all isolates were resistant to at least three classes of antibiotics. In addition, clonal dissemination among the three hospitals located in two different cities in China, previously documented in many regions of Europe and Asia-Pacific nations, emphasises the epidemic potential of these MDRAB isolates.

摘要

迄今为止,有关来自中国不同军队医院的多重耐药鲍曼不动杆菌(MDRAB)临床分离株的易感性模式和分子特征的报道甚少。在本研究中,2007 年从三所军队医院收集了 49 株 MDRAB 菌株。测定了每株菌对 13 种抗生素的最小抑菌浓度(MIC)。使用重复序列基聚合酶链反应(rep-PCR)DiversiLab 微生物分型系统对 MDRAB 菌株进行基因分型和聚类分析。通过 PCR 筛选检测主要克隆类型中每个耐药表型相关的各种基因的分布。除多粘菌素 B 外,对大多数测试抗生素的耐药率在 75.5%至 100%之间变化。两种 DiversiLab rep-PCR 克隆(A 和 B)在三个不同城市的三所医院中广泛存在,一种克隆(D)仅存在于两个位于同一城市(北京)的医院中,另外两种克隆(C 和 E)仅存在于一家医院中。此外,本研究表明,在 MDRAB 分离株中,介导对结构上无关的抗菌药物的耐药性的 intI1、ISAba1、bla(OXA-23)、bla(ADC)、adeB、adeJ、abeM 和 tet(B)基因的分布很高。这些结果表明,所有分离株至少对三类抗生素具有耐药性。此外,在中国两个不同城市的三所医院之间发生的克隆传播,在欧洲和亚太国家的许多地区都有记录,强调了这些 MDRAB 分离株的流行潜力。

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