耐碳青霉烯类抗生素和替加环素的 OXA-23 型菌株不断增加，后者可作为替代联合治疗方案。

Growing OXA-23 type strains among carbapenem-resistant and tigecycline as an alternate combination therapy.

机构信息

Department of Infectious Diseases and Clinical Microbiology, Polatlı Duatepe State Hospital, Ankara, Turkey.

Department of Infectious Diseases & Clinical Microbiology, Ankara Atatürk Training and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey.

出版信息

Turk J Med Sci. 2016 Dec 20;46(6):1894-1899. doi: 10.3906/sag-1508-20.

DOI:10.3906/sag-1508-20

PMID:28081345

Abstract

BACKGROUND/AIM: The increasing prevalence and global spread of difficult-to-treat carbapenem-resistant Acinetobacter baumannii has become a serious problem. The aim of this study is to investigate the resistance patterns and tigecycline sensitivity of carbapenem-resistant A. baumannii strains.

MATERIALS AND METHODS

Acinetobacter strains that were carbapenem-resistant and collected mainly from intensive care units were included into this study. The antibiotic sensitivity/resistance of the strains to other antibiotics and tigecycline were noted. Presence of blaOXA-23, blaOXA-48, blaOXA-58, and NDM-1 was investigated by PCR.

RESULTS

In total, 44 carbapenem-resistant A. baumannii strains were detected. In addition, 57% (25/44) showed resistance to netilmicin and 2% (1/43) to tigecycline. All of the strains were susceptible to colistin. blaOXA-58 was found only in one (2%) strain while blaOXA-23 was found in 14 (32%) strains. All strains were negative for blaOXA-48 and NDM-1.

CONCLUSION

blaOXA-23 was the main resistance pattern in carbapenem-resistant A. baumannii strains. blaOXA-58 was present only in one strain and no blaOXA-48 was found. Tigecycline susceptibility is high and it can be a treatment option for a possible combination therapy of carbapenem-resistant A. baumannii, especially for those for whom colistin is contraindicated because of its toxicity.

摘要

背景/目的：难以治疗的碳青霉烯类耐药鲍曼不动杆菌的患病率不断上升和在全球范围内的传播已成为一个严重的问题。本研究旨在研究碳青霉烯类耐药鲍曼不动杆菌菌株的耐药模式和替加环素敏感性。

材料和方法

本研究纳入了主要从重症监护病房收集的碳青霉烯类耐药的不动杆菌菌株。记录了菌株对其他抗生素和替加环素的抗生素敏感性/耐药性。通过 PCR 研究 blaOXA-23、blaOXA-48、blaOXA-58 和 NDM-1 的存在情况。

结果

共检测到 44 株碳青霉烯类耐药鲍曼不动杆菌。此外，57%（25/44）对奈替米星耐药，2%（1/43）对替加环素耐药。所有菌株均对黏菌素敏感。仅在 1 株（2%）中发现 blaOXA-58，而在 14 株（32%）中发现 blaOXA-23。所有菌株均为 blaOXA-48 和 NDM-1 阴性。