摘 要：目的 探讨泛耐药鲍氏不动杆菌氨基糖苷类抗菌药物耐药机制。方法 收集2014年湖北省黄石市中心医院住院患者中分离的20株泛耐药鲍氏不动杆菌，用mdfA测序确认菌种，再采用聚合酶链反应法分析16种氨基糖苷类药物获得性耐药相关基因。 结果 20株泛耐药鲍氏不动杆菌共检出4种氨基糖苷类获得性耐药基因，氨基糖苷类修饰酶基因aac（3）-Ⅰ阳性率15.00%;ant（3"）-Ⅰ阳性率20.00%;aph3"-Ⅰ阳性率100.00%;16SrRNA甲基化酶未检出;外排泵adeB基因阳性率95.00%。 结论 泛耐药鲍氏不动杆菌中携带的耐药基因和耐药表型相对应，对氨基糖苷类药物耐药与产aac（3）-Ⅰ、ant（3"）-Ⅰ、aph3"-Ⅰ修饰酶基因和获得外排泵adeB 2种耐药机制有关。
关键词：鲍氏不動杆菌;氨基糖苷类修饰酶基因;外排泵基因;泛耐药
中图分类号：R378 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.05.025
文章编号：1006-1959（2018）05-0078-03
Study on Aminoglycoside Pan Resistance Related Genes of Acinetobacter Baumannii
BAO Qun-li，KE Jun，HU Fang，ZHANG Li-Hong，HUANG Yan，CHENG Pan，PEN Zi-Tan，WANG Hong-Liang
（Department of Clinical Laboratory，Huangshi Central Hospital，Huangshi 435000，Hubei，China）
Abstract：Objective To investigate the mechanism of aminoglycoside Pan resistance of Acinetobacter baumannii.Methods 20 strains of Pan resistance Acinetobacter baumannii isolated from hospitalized patients in Huangshi central hospital of Hubei province in 2014 were identified by mdfA sequencing.Polymerase chain reaction was used to analyze the acquired resistance related genes of 16 aminoglycosides.Results A total of 4 aminoglycoside-resistant Acinetobacter baumannii strains were detected in 20 Pan-resistant Acinetobacter baumannii strains.The aminoglycoside modifying enzyme gene aac（3）-I was positive in 15.00%;ant（3"）-I The positive rate was 20.00%;aph3"-I，the positive rate was 100.00%;16S rRNA methylase was not detected;the positive rate of adeB gene of the efflux pump was 95.00%.Conclusion The drug-resistance genes in pan-resistant Acinetobacter baumannii correspond to drug resistance phenotypes，and they are resistant to aminoglycosides and produce aac（3）-I，ant（3"）-I，aph3"-I the modification of the enzyme gene and the acquisition of efflux pump adeB are related to two drug resistance mechanisms.
Key words：Acinetobacter baumannii;Aminoglycoside modifying enzyme gene;Efflux pump gene;Pan-resistance
继临床分离到多药耐药的鲍氏不动杆菌（MDRAB）后，更严重的泛耐药鲍氏不动杆菌（XDRAB）与极度耐药鲍氏不动杆菌（PDRAB）在国内外都有分离报告[1-3]。为全面了解XDRAB氨基糖苷类抗菌药物耐药机制，我们对分离自湖北省黄石市中心医院20株XDRAB进行了9种氨基糖苷类修饰酶基因、6种16SrRNA甲基化酶基因以及外排泵adeB基因检测，现报道如下。
1资料与方法