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碳青霉烯类耐药基因研究与多重耐药鲍曼不动杆菌的流行病学特征。

Study on the resistant genes to carbapenems and epidemiological characterization of multidrug-resistant Acinetobacter baumannii isolates.

机构信息

Laboratory Medicine Department, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, China.

出版信息

Microb Drug Resist. 2013 Apr;19(2):117-23. doi: 10.1089/mdr.2012.0049. Epub 2012 Jul 30.

Abstract

The purpose of this study was to examine the carbapenemase-encoding resistance genes and analyze homologous of multidrug-resistant Acinetobacter baumannii (MRAB) isolates from nosocomial infections. Seventy-six A. baumannii strains were collected from inpatients and object surface of devices in intensive care units from May 2008 to February 2011. Antibiotic susceptibility testing of 18 antimicrobial agents was performed. The presence of carbapenemase-encoding resistance genes was investigated by polymerase chain reaction. Genotyping and dendrogram analysis of A. baumannii strains from nosocomial infections were performed using the DiversiLab System. All of the 76 clinical A. baumannii isolates were shown multidrug resistance. The bla(OXA-23) gene was identified in the 76 MRAB strains, while bla(OXA-24), bla(OXA-58), VIM, IMP-1, IMP-4, SIM, and blaNDM-1 were absent in all. Twenty-four A. baumannii strains from the samples with nosocomial infections were classified into four unrelated groups and nine patterns. In conclusion, production of bla(OXA-23) in MRAB is one of the molecular mechanisms responsible for carbapenem resistance. The MRAB strains from unrelated groups show different drug resistance, but the homologous strains also have different drug resistance. Homologous analysis can provide scientific evidence for evaluation of epidemic status of nosocomial infection caused by MRAB.

摘要

本研究旨在检测耐碳青霉烯类抗生素鲍曼不动杆菌(CRAB)的耐药基因,并对医院感染的多重耐药鲍曼不动杆菌(MRAB)分离株进行同源性分析。2008 年 5 月至 2011 年 2 月,从重症监护病房住院患者和设备物体表面采集了 76 株鲍曼不动杆菌。采用纸片扩散法对 18 种抗菌药物进行药敏试验,聚合酶链反应检测碳青霉烯酶耐药基因,采用 DiversiLab 系统对医院感染的鲍曼不动杆菌进行基因分型和聚类分析。76 株临床分离的鲍曼不动杆菌均表现为多重耐药。76 株 MRAB 中有 bla(OXA-23)基因,而 bla(OXA-24)、bla(OXA-58)、VIM、IMP-1、IMP-4、SIM 和 blaNDM-1 基因均不存在。24 株来自医院感染样本的鲍曼不动杆菌分为 4 个无关群和 9 个模式。总之,MRAB 中产 bla(OXA-23)是导致碳青霉烯类耐药的分子机制之一。来自不同群组的 MRAB 菌株表现出不同的耐药性,但同源菌株也有不同的耐药性。同源性分析可为评价 MRAB 引起的医院感染的流行状况提供科学依据。

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