多重耐药鲍曼不动杆菌耐药性及16S rRNA甲基化酶基因检测的意义

目的：探讨多重耐药鲍曼不动杆菌的耐药性及16SrRNA甲基化酶基因检测的临床意义，为临床合理使用抗生素和控制院内感染提供依据。方法收集2011年3月至2013年12月在南昌市第二人民医院住院的ICU患者各种临床标本分离的多重耐药鲍曼不动杆菌52株。采用纸片扩散（K-B）法对52株多重耐药鲍曼不动杆菌行抗生素药敏试验，采用聚合酶链反应（PCR）检测16SrRNA甲基化酶基因（armA、rmtA、rmtB、rmtC、rmtD、rmtE和npmA基因）表达情况。结果52株多重耐药鲍曼不动杆菌对米诺环素、头孢哌酮/舒巴坦、美罗培南和亚胺培南耐药率分别为44．2％、53．8％、75．0％和78．8％，对其余14种抗生素耐药率均在90．0％以上。52株多重耐药鲍曼不动杆菌中有38株检出armA基因表达，表达率为73．1％（38/52）；其余均未检出。结论多重耐药鲍曼不动杆菌主要携带armA型16SrRNA甲基化酶耐药基因。米诺环素、头孢哌酮/舒巴坦对多重耐药鲍曼不动杆菌有较好的抗菌活性，而多重耐药鲍曼不动杆菌对其他多种抗生素呈多重耐药性。

Antibiotic Resistance of Multidrug-Resistant Acinetobacter Baumannii and Significance of 16S rRNA Methylase Gene Detection

Objective To investigate the antibiotic resistance of multidrug-resistant Acineto-bacter baumannii and clinical significance of 16S rRNA methylase gene detection,and to provide a basis for the rational use of antibiotics and the control of nosocomial infection.Methods Fifty-two strains ofmultidrug-resistant Acinetobacter baumannii isolated from clinical specimens between March 2011 and December 2013 in ICU of Nanchang Second People’s Hospital were col-lected.The disk diffusion（K-B）method was used for the antibiotic susceptibility testing of tidrug-resistant Acinetobacter baumannii.PCR assay was used for the detection of expression of 16S rRNA methylase genes（armA,rmtA,rmtB,rmtC,rmtD,rmtE,and npmA）.Results The resistant rates of the 52 strains of multidrug-resistant Acinetobacter baumannii to minocycline,cefopera-zone/sulbactam,meropenem and imipenem were 44.2%,53.8%,75.0% and 78.8%,respectively. The resistant rates to other 14 kinds of antibiotics were more than 90.0%.Among the 52 strains of multidrug-resistant Acinetobacter baumannii,the expression of armA gene was found in 38 （73.1%）.The rest were not detection.Conclusion Multidrug-resistant Acinetobacter baumannii＆amp;nbsp;mainly carry the 16S rRNA methylase gene armA.Minocycline,cefoperazone and sulbactam have good antibacterial activity against multidrug-resistant Acinetobacter baumannii.However,multi-drug-resistant Acinetobacter baumannii are multidrug-resistant to other antibiotics.