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Molecular mechanism of multiple-drug and pan-drug resistance among Acinetobacter species
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- Author:
- No author available
- Journal Title:
- NATIONAL MEDICAL JOURNAL OF CHINA
- Issue:
- 1
- DOI:
- 10.3760/j:issn:0376-2491.2006.01.007
- Key Word:
- 不动杆菌属;抗药性
Abstract： 目的调查β内酰胺酶、整合子、外膜蛋白(Omp)及外排泵在多重耐药和泛耐药不动杆菌属中所起的作用.方法收集1999至2004年北京、广州和福州对碳青霉烯类耐药的非重复的90株菌.脉冲场凝胶电泳(PFGE)和随机引物多态性DNA(RAPD)分型确定这些耐药株的亲缘关系,选取7个不同克隆深入研究其机制.等电聚焦电泳测定酶的等电点;碱裂解法提取质粒;对各种β内酰胺酶TEM、SHV、PER、OXA-、IMP-、VIM-进行聚合酶链反应(PCR)及序列分析;对整合子基因进行PCR及序列分析.结果 2004年北京协和医院发生泛耐药株P克隆的暴发流行,此克隆株对常用广谱抗菌药物均不敏感.7个不同克隆株均产多种β内酰胺酶:TEM-1酶、高产AmpC酶、SHV型酶、OXA-23型碳青霉烯酶(6株)及IMP-8型金属酶(1株),1个克隆株还产PER-1型酶.这7个克隆株对大多数超广谱β内酰胺类(包括碳青霉烯类)、红霉素、氯霉素、利福平均耐药,2个克隆株对头孢哌酮/舒巴坦、阿米卡星敏感,4个克隆株对左氧氟沙星敏感.所有7株对米诺环素、黏菌素敏感.发现5种不同结构的整合子,携带水解氨基糖苷类、利福平、氯霉素及碳青霉烯类(blaIMP-8)的耐药基因.结论不动杆菌产生OXA-23型碳青霉烯酶或IMP型金属酶、通过基因重组获得各种携带不同基因盒的整合子,共同介导其多重耐药性或泛耐药性.泛耐药株对个别不常用的抗菌药物如黏菌素、米诺环素仍敏感.
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