Zhao Su-ying, Jiang Dong-yang, Xu Peng-cheng, Zhang Yi-kai, Shi Heng-fang, Cao Hui-ling, Wu Qian
Department of Laboratory Medicine, Jiangsu provincial hospital of Traditional Chinese Medicine, Nanjing, China.
The State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.
Ann Clin Microbiol Antimicrob. 2015 Feb 3;14:7. doi: 10.1186/s12941-015-0066-4.
To investigate the drug resistant gene profiles and molecular typing of Acinetobacter baumannii isolates collected from clinical specimens in a comprehensive hospital, Jiangsu province.
This study included 120 patients in a comprehensive hospital with drug-resistant A. baumannii infections on clinical specimens from October 2011 to December 2013. Antibiotic susceptibility test was determined by Vitek 2 Compact system. OXA-51, OXA-23, OXA-24, OXA-58, VIM, IMP, SHV, GES, TEM, AmpC, qacEΔ1-sul1, intI l, CarO, aac(6')-Ib, and aac(6')-II were analyzed by PCR. The analysis of molecular typing for 50 multidrug resistant A. baumannii isolates was performed by PFGE.
A total of 64(53%) isolates were multidrug-resistant A.baumannii. The antibiotic susceptibility tests showed that the resistant rates to common antibiotics of mutidrug-resistant A. baumannii were extremely high, most of which over 60%. One hundred and ten isolates harbored OXA-51 (91.7%), 100 for OXA-23(83.3%), 103 for VIM-1(85.8%), 90 for AmpC(75.00%), 50 for aac(6')-Ib(41.7%), 77 for the loss of CarO (64.2%), 85 for intl1(70.8%), and 64 for qacEΔ1-sul1(53.33%), while OXA-24 was undetected. Fifty multidrug-resistant A. baumannii isolates belong to 14 clones according to the PFGE DNA patterns. Main clone A includes 24 isolates, while clone B and clone C includes 6 and 9 isolates, respectively and others with no common source identified.
There is high morbidity of A. baumannii infections in the hospital, especially in ICU and sputum is the most common sample type.The mainly drug-resistant genes of A. baumannii are OXA-51, OXA-23, and VIM-1 in the hospital. Clonal dissemination provides evidence for the prevalence of multidrug-resistant A. baumannii among clinical isolates. It is suggested that there is an urgent need for effective control and prevention measures.
调查江苏省某综合性医院临床标本中分离的鲍曼不动杆菌的耐药基因谱及分子分型。
本研究纳入了2011年10月至2013年12月期间某综合性医院120例临床标本中感染耐多药鲍曼不动杆菌的患者。采用Vitek 2 Compact系统进行药敏试验。通过PCR分析OXA-51、OXA-23、OXA-24、OXA-58、VIM、IMP、SHV、GES、TEM、AmpC、qacEΔ1-sul1、intI1、CarO、aac(6')-Ib和aac(6')-II。对50株耐多药鲍曼不动杆菌进行PFGE分子分型分析。
共64株（53%）分离株为耐多药鲍曼不动杆菌。药敏试验显示，耐多药鲍曼不动杆菌对常用抗生素的耐药率极高，多数超过60%。110株分离株携带OXA-51（91.7%），100株携带OXA-23（83.3%），103株携带VIM-1（85.8%），90株携带AmpC（75.00%），50株携带aac(6')-Ib（41.7%），77株缺失CarO（64.2%），85株携带intl1（70.8%），64株携带qacEΔ1-sul1（53.33%），未检测到OXA-24。根据PFGE DNA图谱，50株耐多药鲍曼不动杆菌分离株属于14个克隆。主要克隆A包括24株分离株，克隆B和克隆C分别包括6株和9株分离株，其他分离株无共同来源。
该医院鲍曼不动杆菌感染发病率高，尤其是在重症监护病房，痰液是最常见的标本类型。该医院鲍曼不动杆菌的主要耐药基因是OXA-51、OXA-23和VIM-1。克隆传播为临床分离株中耐多药鲍曼不动杆菌的流行提供了证据。建议迫切需要有效的控制和预防措施。
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