目的 研究耐碳青霉烯类鲍曼不动杆菌的流行与耐药机制,为医院治疗和预防鲍曼不动杆菌提供依据.方法 本研究共收集海南医学院第二附属医院住院患者临床分离的243 株耐碳青霉烯类鲍曼不动杆菌,所有菌株按照统一的操作规程进行药敏试验,采用PCR检测碳青霉烯类耐药基因.结果 243 株耐碳青霉烯类鲍曼不动杆菌中,主要来自ICU 68 株(27.98%),痰液标本149 株(61.32%);9 种常用抗菌药物的耐药率>90%,其中替卡西林/棒酸耐药率最高为100.00%,多黏菌素B未出现耐药情况;5 种耐药基因检出率分别为blaOXA23(88.07%)、blaOXA51(88.07%)、blaNDM(23.05%)、blaOXA58(11.93%)及blaOXA24(2.88%).结论 对耐碳青霉烯类鲍曼不动杆菌的耐药情况监控有助于医院加强抗菌药物的使用和管理,防止产生耐药菌株的产生与蔓延.
Objective To study the prevalence and drug resistance mechanism of carbapenem-resistant of Acinetobacter baumannii in the Second Affiliated Hospital of Hainan Medical University,and to provide the basis for the treatment and prevention of Acinetobacter baumannii in local hospitals.Methods A total of 243 strains of penicillin resistant Acinetobacter baumannii isolated from hospitalized patients in the Second Affiliated Hospital of Hainan Medical College were collected in this study.All strains were tested for carbapenem-resistant genes using multiplex PCR in accordance with the uniform operating procedures.Results Among 243 strains of carbapenem-resistant Acinetobacter baumannii,the majority originated from the ICU with 68 strains(27.98%),followed by 149 strains(61.32%) isolated from sputum samples.The resistance rates to 9 commonly used antimicrobial drugs were above 90%.The highest resistance rate was observed for ticarcillin/clavulanate at 100.00%,while colistin showed no resistance.The detection rates of 5 resistance genes were as follows: blaOXA23 (88.07%),blaOXA51 (88.07%),blaNDM(23.05%),blaOXA58 (11.93%),and blaOXA24 (2.88%).Conclusion Monitoring the resistance of carbapenemase- resistant of Acinetobacter baumannii is helpful to strengthen the use and management of antibiotics in hospitals,and prevent the emergence and spread of drug-resistant strains.