浙江浦江耐药鲍氏不动杆菌分离株获得性耐药元件研究

Investigation of acquired resistant genes and mobile genetic elements indrug-resistant Acinetobacter baumannii isolated from Pujiang, Zhejiang province

  • 摘要: 目的 调查鲍氏不动杆菌获得性耐药基因和可移动遗传元件标记的携带情况,以及菌株间的亲缘关系,了解其耐药机制及流行病学情况。方法 收集2015年1-12月浙江省浦江县人民医院患者标本中分离鲍氏不动杆菌20株,采用聚合酶链反应(PCR)的方法分析32种β-内酰胺类药物获得性耐药基因、15种氨基糖苷类药物获得性耐药基因、10种可移动遗传元件遗传标记,再对检测结果作样本聚类分析(UPGMA法)。结果 20株鲍氏不动杆菌共检出4种β-内酰胺类获得性耐药基因(blaTEMblaADCblaOXA-23群、blaOXA-66),3种氨基糖苷类获得性耐药基因(aac(3)-Ⅰ、aac(6')-Ⅰb、ant(3″)-Ⅰ),5种可移动遗传元件遗传标记(intⅠ1、tnpU、tnp513、ISaba1、IS26);阳性基因检出率高,可分为6种阳性模式;样本聚类分析显示,菌株分为A与B两个群,并均存在克隆传播:A群的1-2-4-5-7-9-17-19号株,3-10号株等, B群的16-18号株,6-14-20号株,8-11-12-13号株。结论 鲍氏不动杆菌检出β-内酰胺类和氨基糖苷类药物的获得性耐药基因是对该二类药物耐药的主要原因,并且这些获得性耐药基因由可移动遗传元件介导,获得菌株之间的亲缘关系对院内感染实时监测和控制医院感染意义重大。

     

    Abstract: OBJECTIVE To investigate the distribution of acquired resistant genes and mobile genetic elements,and phylogenetic analysis among agroup of drug-resistant Acinetobacter baumannii,so as to understand the drug-resistant mechanism and epidemiological situation.METHODS A total of 20 strains of A.baumannii were collected from the Pujiang People′s Hospital,Zhejiang Province in 2015.Then,resistance genes were analyzed by PCR,including 32 kinds of acquired beta-lactamase genes,15 kinds of acquired resistant genes to aminoglycosides,and 10 kinds of genetic markers of mobile genetic elements.In addition,sample cluster analysis was performed(UPGMA).RESULTS Totally 4kinds of acquired beta-lactamase genes(blaTEM,blaADC,blaOXA-23 group,and blaOXA-66),3kinds of acquired resistant genes to aminoglycosides(aac(3)-Ⅰ,aac(6′)-Ⅰb,and ant(3″)-Ⅰ),5kinds of genetic markers of mobile genetic elements(intⅠ1,tnpU,tnp513,ISaba1,and IS26)were positive in20 strains of A.Baumannii,and positive rates were high,and were divided into 6kinds of positive models.Sample cluster analysis showed that strains were divided into cluster A and B,and clones existed in 2clusters:strain No.1-2-4-5-7-9-17-19 and strain No.3-10 in cluster A,and strain No.16-18,strain No.6-14-20,strain No.8-11-12-13 in cluster B.CONCLUSION Acquired resistant genes to beta-lactams and aminoglycosides in this group of A.baumannii played a key role in resistance to beta-lactams and aminoglycosides,and these genes were mediated by mobile genetic elements.It is important to monitor and control noscomial infection intime depending on phylogenetic analysis among strains.

     

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