Epidemiology and resistance mechanism study of carbapenem-resistant Acinetobacter baumannii

doi:10.3969/j.issn.1673-8640.2015.01.013

Abstract

Abstract:

Objective To understand the drug resistance mechanisms and epidemiology of carbapenem-resistant Acinetobacter baumannii in order to guide the rational use of antibiotics and to provide the reference for the control of nosocomial infections. Methods A total of 116 Acinetobacter baumannii (110 carbapenem-resistant isolates and 6 carbapenem-sensitive isolates) isolated from clinical specimens were classified and analyzed according to endemic areas and specimen types. The isolates were analyzed by repetitive-sequence polymerase chain reaction (REP-PCR) for genotyping. Beta-lactamase genes (OXA, IMP, VIM and soon) and efflux pump-encoding genes (adeA, adeB, adeC, adeJ, adeG) were amplified by PCR. Real-time fluorescence quantitation PCR was performed to compare the expression level of the efflux pump-encoding genes in resistant and sensitive isolates. Results The isolation rate of resistant isolates in intensive care unit (ICU) was the highest-level, and the isolates were mainly isolated from sputum. The genotype types of carbapenem-resistant and -sensitive Acinetobacter baumannii were classified into 7 categories by REP-PCR. All the carbapenem-resistant isolates were type A. OXA-23 and OXA-51 were positive in 110 carbapenem-resistant isolates. However, OXA-24, OXA-58, IMP-1, IMP-2, VIM-1 and VIM-2 could not be detected in all the isolates. The positive rates of the efflux pump-encoding genes (adeA, adeB, adeC, adeJ and adeG) were 100%. The expression level of efflux pump-encoding genes (adeA, adeB, adeC) in resistant isolates was significantly higher than that in sensitive isolates. Conclusions The main popular type of carbapenem-resistant Acinetobacter baumannii is type A. Clinical staff should pay attention to this phenomenon. The expression of OXA-23 and OXA-51 overexpression of adeA, adeB and adeC efflux pump-encoding gene may play an important role in carbapenem-resistant Acinetobacter baumannii.

Key words: Acinetobacter baumannii, beta-lactamase, Efflux pump, Repetitive-sequence polymerase chain reaction, Real-time fluorescence quantitation polymerase chain reaction

CLC Number:

R446.5

ZHANG Guanghui, CAO Xueping, YU Jing, LIU Ying, GE Yan. Epidemiology and resistance mechanism study of carbapenem-resistant Acinetobacter baumannii[J]. Laboratory Medicine, 2015, 30(1): 53-57.

Figures/Tables 6

References 16

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引物	引物序列	预期长度 (bp)	参考文献
OXA-23	P1 5'-GATCGGATTGGAGAACCAGA-3'	501	[4]
	P2 5'-ATTTCTGACCGCATTTCCAT-3'
OXA-24	P1 5'-GGTTAGTTGGCCCCCTTAAA-3'	246	[4]
	P2 5'-AGTTGAGCGAAAAGGGGATT-3'
OXA-51	P1 5'-TAATGCTTTGATCGGCCTTG-3'	353	[4]
	P2 5'-TGGATTGCACTTCATCTTGG-3'
OXA-58	P1 5'-AAGTATTGGGGCTTGTGCTG-3'	599	[4]
	P2 5'-CCCCTCTGCGCTCTACATAC-3'
IMP-1	P1 5'-ACCGCAGCAGAGTCTTTGCC-3'	587	[5]
	P2 5'-ACAACCAGTTTTGCCTTACC-3'
IMP-2	P1 5'-GTTTTATGTGTATGCTTCC-3'	678	[5]
	P2 5'-AGCCTGTTCCCATGTAC-3'
VIM-1	P1 5'-AGTGGTGAGTATCCGACAG-3'	261	[5]
	P2 5'-ATGAAAGTGCGTGGAGAC-3'
VIM-2	P1 5'-ATGTTCAAACTTTTGAGTAAG-3'	801	[5]
	P2 5'-CTACTCAACGACTGAGCG-3'
adeA	P1 5'- GGGTGTGATTCAAAAGAAGTCGC-3'	169	[6]
	P2 5'-GAACCTTTTCAATGATACCTCCG-3'
adeB	P1 5'-AAAGACTTCAAAGAGCGGACTA-3'	623	[7]
	P2 5'-TCACGCATTGCTTCACCC-3'
adeC	P1 5'-ACAATCGTATCTCGTGGACTC-3'	361	[6]
	P2 5'-TAGAAACTGGGTTATTGGGGT-3'
adeJ	P1 5'-CCTATTGCACAATATCCAACGA-3'	119	[8]
	P2 5'-AGGATAAGTCGCAGCAATCG-3'
adeG	P1 5'-GTCCTGAAATGGTCGTTCGT-3'	143	[8]
	P2 5'-AGCTTCTGCTTGGCTAGATGA-3'
rpoB	P1 5'-TTCATCTAGCCAAGCAGAAG-3'	200	[9]
	P2 5'-CCTGCTAATGGTAGGGTTAAG-3'

引物	引物序列	预期长度 (bp)	参考文献
OXA-23	P1 5'-GATCGGATTGGAGAACCAGA-3'	501	[4]
	P2 5'-ATTTCTGACCGCATTTCCAT-3'
OXA-24	P1 5'-GGTTAGTTGGCCCCCTTAAA-3'	246	[4]
	P2 5'-AGTTGAGCGAAAAGGGGATT-3'
OXA-51	P1 5'-TAATGCTTTGATCGGCCTTG-3'	353	[4]
	P2 5'-TGGATTGCACTTCATCTTGG-3'
OXA-58	P1 5'-AAGTATTGGGGCTTGTGCTG-3'	599	[4]
	P2 5'-CCCCTCTGCGCTCTACATAC-3'
IMP-1	P1 5'-ACCGCAGCAGAGTCTTTGCC-3'	587	[5]
	P2 5'-ACAACCAGTTTTGCCTTACC-3'
IMP-2	P1 5'-GTTTTATGTGTATGCTTCC-3'	678	[5]
	P2 5'-AGCCTGTTCCCATGTAC-3'
VIM-1	P1 5'-AGTGGTGAGTATCCGACAG-3'	261	[5]
	P2 5'-ATGAAAGTGCGTGGAGAC-3'
VIM-2	P1 5'-ATGTTCAAACTTTTGAGTAAG-3'	801	[5]
	P2 5'-CTACTCAACGACTGAGCG-3'
adeA	P1 5'- GGGTGTGATTCAAAAGAAGTCGC-3'	169	[6]
	P2 5'-GAACCTTTTCAATGATACCTCCG-3'
adeB	P1 5'-AAAGACTTCAAAGAGCGGACTA-3'	623	[7]
	P2 5'-TCACGCATTGCTTCACCC-3'
adeC	P1 5'-ACAATCGTATCTCGTGGACTC-3'	361	[6]
	P2 5'-TAGAAACTGGGTTATTGGGGT-3'
adeJ	P1 5'-CCTATTGCACAATATCCAACGA-3'	119	[8]
	P2 5'-AGGATAAGTCGCAGCAATCG-3'
adeG	P1 5'-GTCCTGAAATGGTCGTTCGT-3'	143	[8]
	P2 5'-AGCTTCTGCTTGGCTAGATGA-3'
rpoB	P1 5'-TTCATCTAGCCAAGCAGAAG-3'	200	[9]
	P2 5'-CCTGCTAATGGTAGGGTTAAG-3'

按标本种类划分		按病区划分
来源	菌株数	病区	菌株数
痰液	77	ICU	49
胸、腹腔引流液	11	心胸外科病区	14
全血(包括静脉穿刺)	9	脑外科病区	13
脑脊液	4	干部病区	10
咽拭子	4	呼吸科病区	9
创面分泌物	3	急诊病区	7
气管插管	2	其它科室	8

按标本种类划分		按病区划分
来源	菌株数	病区	菌株数
痰液	77	ICU	49
胸、腹腔引流液	11	心胸外科病区	14
全血(包括静脉穿刺)	9	脑外科病区	13
脑脊液	4	干部病区	10
咽拭子	4	呼吸科病区	9
创面分泌物	3	急诊病区	7
气管插管	2	其它科室	8