29株耐亚胺培南和/或美罗培南鲍曼不动杆菌产碳青霉烯酶基因型检测

目的 了解临床分离耐亚胺培南和/或耐美罗培南鲍曼不动杆菌中产碳青霉烯酶的基因型别.方法 采用聚合酶链反应扩增IMP、VIM、OXA型碳青霉烯酶基因并测序.结果 29株对碳青霉烯类耐药的鲍曼不动杆菌中,以产OXA-24型和IMP型酶菌株最多,二者均占51.7％ (15/29).产OXA-24+ IMP型5株、OXA-24+ OXA-51+IMP型4株、VIM型4株、OXA-24+ OXA-58+ IMP型、OXA-23+ OXA-24+ IMP型各2株,OXA-23+IMP型、OXA-51+OXA-24型、OXA-24型、IMP型各1株,8株细菌PCR检测结果为阴性.结论 耐亚胺培南和/或美罗培南鲍曼不动杆菌主要产OXA-24型和IMP型碳青霉烯酶,部分菌株可同时产2种或以上碳青霉烯酶.     

皖北地区耐碳青霉烯鲍曼不动杆菌产金属β-内酰胺酶检测

目的了解皖北地区ICU病房内耐碳青霉烯鲍曼不动杆菌产金属β-内酰胺酶（metallo-β-lactamase,MBL）情况。方法收集皖北地区3家教学医院ICU病房中不动杆菌,K-B纸片扩散法检测其对碳青霉烯类抗生素耐药情况;PCR法检测blaIMP、blaVIM等MBL基因。结果共收集35株耐亚胺培南、美罗培南非重复分离鲍曼不动杆菌菌株,其中9株（25.7%）金属酶初筛阳性;PCR检测5株（5/35,14.3%）产IMP型MBL,1株（1/35,2.9%）VIM型MBL。结论在本地区耐碳青霉烯鲍曼不动杆菌中首次发现IMP和VIM型金属酶,提示产金属酶机制参与本地区鲍曼不动杆菌对碳青霉烯耐药,值得进一步关注。     

鲍曼不动杆菌的耐药情况及碳青霉烯酶基因检测

了解佳木斯大学附属第一医院鲍曼不动杆菌耐药性及碳青霉烯酶包括苯唑西林酶和金属酶相关耐药基因分布情况,为临床抗菌药物的合理选择提供依据。2013年9月至2014年12月使用VITEK-II全自动微生物鉴定/药敏测试系统筛选出佳木斯大学附属第一医院临床标本鲍曼不动杆菌69株;采用多重PCR方法检测鲍曼不动杆菌携带的碳青霉烯酶相关耐药基因16SrRNA、OXA-23、OXA-24、OXA-51、OXA-58、IMP、VIM、SIM,并对耐药基因扩增的阳性产物进行DNA 序列分析。69株AB对亚胺培南、美洛培南的耐药率分别为36.2%、37.68%,对其他抗菌药物的耐药率均高于50%。6种耐药基因的检测结果为69株(100%)携带OXA-51基因,32株(46.4%)携带OXA-23基因,17株(24.6%)携带OXA-24基因,5株(7.2%)携带OXA 58基因,1株（1.4%）携带IMP基因。25株碳青霉烯类药物耐药鲍曼不动杆菌中,22株(88%) 携带OXA-23,1株(4%)携带OXA-58,10株(40%)携带OXA-24,6株（24%）同时携带OXA-23、OXA-24。 DNA序列分析结果显示：OXA-23、OXA-24、OXA-51、OXA-58分别与NCBI的序列同源性均为99%。产OXA-23型碳青霉烯酶可能是佳木斯大学附属第一医院鲍曼不动杆菌对碳青霉烯酶类抗菌药物耐药的主要原因,另外佳木斯大学附属第一医院存在OXA-24型耐药基因鲍曼不动杆菌的区域性流行。     

鲍曼不动杆菌耐药性监测与碳青霉烯酶基因型研究

目的:对鲍曼不动杆菌耐药性及碳青霉烯酶基因型进行研究,以指导临床合理应用抗生素。方法:收集青岛市海慈医疗集团2009年6月至2010年6月从临床分离的鲍曼不动杆菌60株,用琼脂稀释法测定最低抑菌浓度(M IC),改良Hodge试验检测碳青霉烯酶,用PCR法检测OXA-23,OXA-24,OXA-58基因,并对PCR产物进行测序。结果:①鲍曼不动杆菌检出率前两位是ICU病房和呼吸科病房,分别占32.3%和27.4%,多重耐药鲍曼不杆菌阳性率最高的是ICU,为70.6%(12/17),其次为呼吸科病房,为35.0%(7/20),哌拉西林、哌拉西林/他唑巴坦、头孢曲松、头孢他啶、头孢吡肟、亚胺培南、美罗培南、庆大霉索、阿米卡星、环丙沙星、左氧氟沙星、加替沙星、头孢哌酮/舒巴坦、氨曲南耐药率分别为92.3%、55.4%、88.6%、86.3%、80.3%、30.0%、35.0%、76.6%、79.6%、75.1%、87.1%、48.3%、42.0%和79.6%.②在21株耐碳青霉烯类鲍曼不动杆菌,有14株碳青霉烯酶表型阳性,检出率为66.7%,有18株PCR扩增出OXA-23基因,检出率85.7%,全部菌株blaOXA-24及blaOXA-58PCR扩增均为阴性,PCR产物测序表明与鲍曼不动杆菌(AY795964.1)blaOXA-23基因序列100%同源。结论:鲍曼不动杆菌多重耐药性严重;表型和基因型检测证实本院临床分离鲍曼不动杆菌对碳青霉烯类耐药机制主要是产OXA-23型酶。     

危重病房耐碳青霉烯酶鲍曼不动杆菌同源性研究

目的探讨杭州市第一医院危重病房耐碳青霉烯酶鲍曼不动杆菌之间的同源性,进行分子流行病学调查,旨在为制定预防和控制其院内感染的措施提供依据。方法收集该院危重病房2005年1月至12月分离到的34株亚胺培南耐药鲍曼不动杆菌。采用全自动微生物分析系统VITEK-AMS60对34株耐碳青霉烯酶鲍曼不动杆菌进行鉴定及药敏;用琼脂稀释法和E-test法测定14种抗菌药物的最低抑菌浓度(MIC),脉冲场凝胶电泳(PF-GE)分析其耐药株的同源性,对碳青霉烯类基因OXA-23型、OXA-24型、IMP型、VIM型基因进行PCR扩增及序列分析。结果PFGE发现34株鲍曼不动杆菌菌株为同一耐药克隆株,在危重病房呈爆发流行。所有对亚胺培南耐药鲍曼不动杆菌明确产OXA-23型碳青霉烯酶,未检出OXA-24、IMP、VIM基因型。34株菌株质粒提取未成功。结论该院同一个耐药克隆株在危重病房不同患者身上流行,可能与行气管插管、呼吸机、氧气湿化瓶、护士手操作有关。     

426株鲍曼不动杆菌的耐药性分析与OXA-23型碳青霉烯酶检测

目的 了解暨南大学附属第一医院2009年至2011年鲍曼不动杆菌的分布特点和耐药状况,为临床合理使用抗生素提供依据,同时研究广州地区亚胺培南耐药鲍曼不动杆菌中OXA-23型碳青霉烯酶的分子流行病学特征.方法 利用梅里埃VITEK-2 Compact微生物分析仪鉴定细菌,K-B法进行药敏试验,采用WHONET 5.6软件统计分析药敏结果,PCR检测OXA-23型碳青霉烯酶的编码基因.结果 2009年至2011年临床分离出426株鲍曼不动杆菌,主要分离自呼吸科病房(119株,占27.9％)和ICU病房(107株,占25.1％),标本类型以痰液为主(361株,占84.7％),鲍曼不动杆菌对12种抗生素的耐药率总体呈逐年上升趋势,对亚胺培南的耐药率从13.2％上升到39.3％,在124株亚胺培南耐药鲍曼不动杆菌中PCR检出98株OXA-23型碳青霉烯酶阳性菌株.结论 鲍曼不动杆菌对各种抗菌药物的耐药性逐年增强,产OXA-23型碳青霉烯酶是其对亚胺培南耐药的主要机制之一.     

鲍曼不动杆菌耐药性监测与碳青霉烯酶基因型研究

目的：对鲍曼不动杆菌耐药性及碳青霉烯酶基因型进行研究,以指导临床合理应用抗生素。方法：收集青岛市海慈医疗集团2009年6月至2010年6月从临床分离的鲍曼不动杆菌60株,用琼脂稀释法测定最低抑菌浓度（M IC）,改良Hodge试验检测碳青霉烯酶,用PCR法检测OXA-23,OXA-24,OXA-58基因,并对PCR产物进行测序。结果：①鲍曼不动杆菌检出率前两位是ICU病房和呼吸科病房,分别占32.3%和27.4%,多重耐药鲍曼不杆菌阳性率最高的是ICU,为70.6%（12/17）,其次为呼吸科病房,为35.0%（7/20）,哌拉西林、哌拉西林/他唑巴坦、头孢曲松、头孢他啶、头孢吡肟、亚胺培南、美罗培南、庆大霉索、阿米卡星、环丙沙星、左氧氟沙星、加替沙星、头孢哌酮/舒巴坦、氨曲南耐药率分别为92.3%、55.4%、88.6%、86.3%、80.3%、30.0%、35.0%、76.6%、79.6%、75.1%、87.1%、48.3%、42.0%和79.6%.②在21株耐碳青霉烯类鲍曼不动杆菌,有14株碳青霉烯酶表型阳性,检出率为66.7%,有18株PCR扩增出OXA-23基因,检出率85.7%,全部菌株blaOXA-24及blaOXA-58PCR扩增均为阴性,PCR产物测序表明与鲍曼不动杆菌（AY795964.1）blaOXA-23基因序列100%同源。结论：鲍曼不动杆菌多重耐药性严重;表型和基因型检测证实本院临床分离鲍曼不动杆菌对碳青霉烯类耐药机制主要是产OXA-23型酶。     

鲍曼不动杆菌中OXA碳青霉烯酶的表型筛选与PCR检测

摘要：目的 了解OXA碳青霉烯酶在暨南大学附属第一医院耐亚胺培南鲍曼不动杆菌中的流行状况,完善OXA碳青霉烯酶的分子流行病学资料。方法 采用改良Hodge试验筛选产碳青霉烯酶菌株,多重PCR法检测OXA碳青霉烯酶的编码基因（blaOXA-23-like、blaOXA-24-like、blaOXA-58-like和blaOXA-143）,利用生物信息学的方法对OXA亚型进行比对分析并制作分子进化树。结果 在157株耐亚胺培南鲍曼不动杆菌中Hodge试验筛选出碳青霉烯酶表型阳性菌株141株,PCR检测结果显示有132株携带OXA-23编码基因,未检测到OXA-24-like、OXA-58-like和OXA-143亚型。结论 产OXA-23碳青霉烯酶是该院鲍曼不动杆菌对亚胺培南耐药的主要机制之一。     

鲍曼不动杆菌耐药性及碳青霉烯酶检测

目的了解临床分离鲍曼不动杆菌对临床常用抗菌药物的耐药性及其产碳青霉烯酶情况,为临床抗感染治疗提供依据。方法采用MicroScan WalkAway-40全自动微生物分析仪对240株临床分离的鲍曼不动杆菌进行鉴定和药敏试验,改良的Hodge试验检测耐碳青霉烯类鲍曼不动杆菌产生的碳青霉烯酶,并采用SPSS 13.0软件进行统计分析。结果 240株鲍曼不动杆菌对亚胺培南的耐药率最低(20.8%),对青霉素类、头孢菌素类、喹诺酮类、复方新诺明的耐药率均大于50%;耐碳青霉烯类鲍曼不动杆菌碳青霉烯酶的检出率为64.0%。结论临床分离鲍曼不动杆菌耐药情况严重,碳青霉烯酶是鲍曼不动杆菌对碳青霉烯类抗菌药物耐药的主要原因。     

耐碳青霉烯类鲍曼不动杆菌OXA和NDM-1耐药基因的研究

目的检测江苏盛泽医院耐碳青霉烯类抗生素鲍曼不动杆菌的OXA和NDM-1耐药基因,分析耐碳青霉烯类抗菌药物的耐药机制。方法采用改良Hodge试验检测30株耐碳青霉烯类抗生素鲍曼不动杆菌产酶情况;用PCR的方法检测OXA-23、OXA-24、VIM、IMP和NDM-1碳青霉烯酶耐药基因。结果 30株分离菌中25株菌改良Hodge试验阳性,22株携带OXA-23型碳青霉烯酶耐药基因,未扩增出NDM-1碳青霉烯酶耐药基因。结论本院耐碳青霉烯类抗生素鲍曼不动杆菌的耐药机制主要是携带OXA-23型碳青霉烯酶基因。     

一株弗劳地枸橼酸杆菌中检出新ampC基因

目的探讨1株耐亚胺培南弗劳地枸橼酸杆菌的耐药机制。方法采用浓度梯度法（Etest）检测对抗菌药物的最低抑菌浓度（MIC）。通过金属酶初筛试验（协同法）检测金属酶;改良Hoged试验检测碳青霉烯酶;头孢西丁三维试验检测AmpC酶;聚合酶链反应（PCR）检测耐药基因;DNA测序决定基因型;接合试验检测耐药基因的转移性。结果弗劳地枸橼酸杆菌临床分离株NC118对亚胺培南的MIC为〉16μg/ml,金属酶初筛试验阴性,Hoged表型确证试验碳青霉烯酶阳性,AmpC酶阳性,PCR扩增及测序显示含有blaKPC-2、blaAmpC基因,该菌株所产AmpC酶基因与CMY-45型AmpC酶（GenBank：ACU00152.1）比较有5个氨基酸发生了改变,该blaCMY-2-like基因为一个新型的AmpC酶基因。结论在弗劳地枸橼酸杆菌中发现一种新的ampC基因（blaCMY-49）。     

The role of bla(OXA-like carbapenemase) and their insertion sequences (ISS) in the induction of resistance against carbapenem antibiotics among Acinetobacter baumannii isolates in Tehran hospitals

This study aimed to evaluate the occurrence and dissemination of bla(OXA-like) carbapenemase genes and their insertion sequences among Acinetobacter baumannii isolates, taken from different hospitals in Tehran city and also their roles in the induction of resistance to carbapenem drugs. A total number of 100 non duplicate Acinetobacter baumannii with different origins, were isolated from patients with proved nosocomial infections at eight university hospital in Tehran city. Antimicrobial susceptibility of these strains was done by E-test against 7 antimicrobial agents according to CLSI guideline. PCR of bla(OXA-51-like), bla(OXA-23-like), bla(OXA-24-like), bla(OXA-58-like), IS(ABA-1), IS(1133) was carried out by specialized primers and then these strains were typed by REP-fingerprinting. Colistin, imipenem and meropenem were the most sensitive antibiotics against Acinetobacter baumannii isolates with 96%, 51% and 51% sensitivity respectively. All the isolates had a bla(OXA-51-like) intrinsic to these species. The rates of bla(OXA-23), 23 and 58-like were 38%, 32% and 1% respectively. Coexistence of bla(OXA-51/23/24-like) was observed among 16% of these isolates. All bla(OXA-23-like) carbapenemase genes had only one IS(ABA1). REP fingerprinting showed 5 genotypes among carbapenem resistant isolates, 16 of them being genotype A. This study emphasized on the major role of bla(OXA-like) carbapenemase, particularly bla(OXA-23-like) carbapenemase and their IS(ABA1), in the dissemination of carbapenem resistant Acinetobacter baumannii. This study confirmed a presumptive role of IS element neighboring the carbapenemase gene in the elevation of resistance to carbapenem drug among Acinetobacter baumannii isolates for the first time in Iran.     

Emerging cystic fibrosis pathogens: incidence and antimicrobial resistance

We examined the frequency of isolation and the antimicrobial resistance of Burkholderia cepacia complex, Stenotrophomonas maltophilia and Achromobacter xylosoxidans in cystic fibrosis patients from 2000 to 2004. Strains susceptibility to tobramycin, piperacillin/tazobactam, imipenem, gentamicin, ciprofloxacin and ceftazidime was determined by disc diffusion assay. B. cepacia complex showed a very high resistance also to ciprofloxacin reaching 100% in 2004. S. maltophilia and A. xvylosoxidans showed high rates of antimicrobial resistance both aminoglycoside and ciprofloxacin. It is very important to monitor the percentage of isolation of these species over time to verify strains resistance to antibiotics and also to test new combinations of antimicrobial agents.     

重症监护室耐亚胺培南鲍曼不动杆菌的耐药性分析

目的探讨温州医学院附属第一医院重症监护室（ICU）耐亚胺培南鲍曼不动杆菌的耐药特性。方法对2006年1月至2007年12月ICU分离的菌株采用常规方法进行菌株分离,经革兰染色、氧化酶试验等初筛,再经VITEK-32型全自动微生物分析仪进行菌株鉴定和药敏试验。结果共检测到98株鲍曼不动杆菌,其中耐亚胺培南的鲍曼不动杆菌为50株（占51.0%）,标本来源大部分为痰液（占94.9%）。耐亚胺培南鲍曼不动杆菌对常用16种抗菌药物耐药率〉50%的有15种,耐药率〉90%有3种,分别为氨苄西林（98.0%）、头孢唑林（99.0%）和呋喃妥因（99.0%）,对抗菌药物耐药率最低仅为头孢哌酮/舒巴坦（10.2%）,另外检测到对所用抗菌素泛耐为4株（8.0%）;而对亚胺培南敏感的鲍曼不动杆菌对常用16种抗菌药物耐药率〉50%的仅为4种,耐药率〉90%同样为氨苄西林（100%）、头孢唑林（97.9%）和呋喃妥因（97.9%）,耐药率比较低的为美罗培南（10.4%）、妥布霉素（16.7%）和环丙沙星（16.7%）,耐药率最低也为头孢哌酮/舒巴坦（6.3%）。结论 ICU分离耐亚胺培南鲍曼不动杆菌多重耐药性严重,出现了泛耐菌株;临床可根据药敏试验选用抗菌药物,一般条件下耐亚胺培南鲍曼不动杆菌建议选用头孢哌酮／舒巴坦。     

Occurrence of a new metallo-beta-lactamase IMP-4 carried on a conjugative plasmid in Citrobacter youngae from the People's Republic of China

During the course of an antimicrobial resistance surveillance programme in Guangzhou, the People's Republic of China, single strains of Citrobacter youngae and Pseudomonas aeruginosa were identified which were resistant to imipenem and found to carry the carbapenemase gene bla(IMP). PCR screening of the citrobacter strain with specific primers for the bla(IMP) type genes gave a 587-bp product which when sequenced gave 100% homology with the bla(IMP-4) sequence reported recently from Acinetobacter spp. The determinant in the C. youngae strain was found to be located on a 156-kb plasmid capable of transfer to Escherichia coli UB1637 by conjugation. Sequencing of the bla(IMP-4) open reading frame in the C. youngae strain and adjacent sequences not only confirmed the presence of bla(IMP-4) but also identified that a conserved core site found within the 59-bp element of integrons was present and the same as the one described in the only other occurrence of bla(IMP-4) in Acinetobacter spp. isolated from an intensive care unit in Hong Kong. This is the second report of transferable carbapenemase genes in Enterobacteriaciae outside of Japan and the first in the People's Republic of China. Under the selective pressure of carbapenems and extended spectrum cephalosporins use we might expect this gene to spread and widespread surveillance should be instituted.     

Survey of susceptibility of clinical Clostridium diffiicile strains isolated from patients hospitalised in different departments of paediatric hospital to antimicrobial agents

This study was performed to determine the susceptibility of 50 C. difficile strains isolated from faecal samples of children suspected to antibiotic associated diarrhea (AAD) to antimicrobial agents: metronidazole, vancomycin, erythromycin, clindamycin, ciprofloxacin, moxifloksacin, gatifloksacin and imipenem. The all C. difficile strains were sensitived to metronidazole and vancomycin. Twenty six per cent of strains were resistant to erythromycin and clindamycin (MLS(B) type resistance). Resitance to ciprofloxacin, moxifloxacin, gatifloxacin and imipenem was detected in 98%, 8%, 8% and 30% of C. difficile strains, respectively.     

耐碳青霉烯鲍曼不动杆菌的临床分布及基因组流行病学分析

【背景】鲍曼不动杆菌是造成临床感染的重要病原菌之一,其对碳青霉烯类抗生素的耐药形势日益严重,利用基因组测序技术解析其临床分布特征和流行病学规律有助于临床感染的有效防治。【目的】研究沧州市中心医院2018年检出的200株耐碳青霉烯鲍曼不动杆菌(carbapenem-resistant Acinetobacter baumannii,CRAB)的临床分布和基因组流行病学特征,以期为预防院内感染及抗感染治疗提供理论依据。【方法】选取2018年各临床科室的耐碳青霉烯鲍曼不动杆菌,采用细菌鉴定及药敏分析仪对16种抗生素进行药敏试验;PCR扩增检测碳青霉烯酶基因;多位点序列分型技术(multilocus sequence typing,MLST)检测菌株序列型;基因组流行病学分析揭示菌株传播关系。【结果】本院CRAB主要分布在急诊重症加强护理病房(intensive care unit,ICU)(47.0%)、呼吸内科(19.5%)和重症医学科(12.0%),它们对亚胺培南、美罗培南、氨苄西林/舒巴坦、环丙沙星、庆大霉素、左旋氧氟沙星、哌拉西林/他唑巴坦、替卡西林/棒酸、阿米卡星及第三四代头孢类抗...     

Antibiotic susceptibility and molecular mechanisms of cephalosporins resistance in Klebsiella isolates from patients with hospital-acquired infections]

Antibiotic susceptibility of nosocomial Klebsiella isolates from inpatients of 30 medical centres in 15 various regions of Russia was studied. In total 212 strains were tested. The Klebsiella genus was represented by the following species: Klebsiella pmeumoniae ss. pneumoniae (182 isolates, 85.8%), Klebsiella pneumonia ss. ozaenae (1 isolate, 0.5%), Klebsiella oxytoca (29 isolates, 13.7%). The susceptibility was determined by the broth microdilution method. Carbapenems (imipenem and meropenem) remained to be the most active antibacterial agents. However, 1 imipenem resistant strain and 2 meropenem resistant strains were isolated. As for the 3rd generation cephalosporins, the lowest MICs were observed with the use of the inhibitor-protected agents, such as ceftazidime/clavulanic acid (MIC50 0.25 mcg/ml, MIC90 64 mcg/ml). 48.8%, 16.9%, 29.7% and only 10.5% of the isolates was susceptible to cefepime, cefotaxime, ceftazidime and cefoperazone respectively. Detecting of the beta-lactamase genes (TEM, SHV and CTX) was performed by PCR in 42 strains of Klebsiella pneumoniae ss. pneumoniae. Alone or in various combination the TEM type beta-lactamases were detected in 16 (38.1%) isolates. SHV and CTX were detected in 29 (69%) and 27 (64.3%) isolates respectively. Combinations of 2 and 3 different determinants of resistance to beta-lactams were revealed in 23.8% and 26.2% of the isolates respectively. No isolates producing class B MBL among the carbapenem resistant nosocomial Klebsiella strains were detected.     

产β-内酰胺酶鲍曼不动杆菌基因型研究

目的了解临床科室分离的鲍曼不动杆菌耐药状况并分析多重耐药株产β-内酰胺酶基因型,为有效的临床治疗和医院感染控制提供实验室依据。方法采用纸片扩散（K-B）法测定临床分离的312株鲍曼不动杆菌对13种抗菌药物的敏感性,对其中120株多重耐药株用聚合酶链反应（PCR）扩增β-内酰胺酶基因,并对其扩增产物进行基因测序。结果鲍曼不动杆菌对美洛培南、亚胺培南、头孢哌酮/舒巴坦和替卡西林/克拉维酸的耐药率分别为0.0%、1.0%、30.8%和31.4%,其余抗菌药物耐药率在38.5%-80.1%;120株多重耐药菌株中,β-内酰胺酶基因分布AmpC型基因阳性率为66.7%（80/120）、SHV-12型基因阳性率为14.2%（17/120）,PER-1型基因阳性率为16.7%（20/120）,CTX-M-9型基因阳性率为8.2%（10/120）,TEM-1型基因阳性率为9.2%（11/120）;VER-1,CTX-M-1,CTX-M-2,OXA型均阴性。同时携带2种基因型有16株,携带3种基因型有14株。结论临床分离的鲍曼不动杆菌流行株主要是产AmpC酶,且呈多重耐药。     

2007-2010四年间鲍曼不动杆菌耐药性变迁及对亚胺培南耐药的机制研究

目的研究2007-2010四年间中山大学附属第一医院临床分离的鲍曼不动杆菌的耐药性迁移情况和耐亚胺培南的鲍曼不动杆菌(IRAB)的耐药机制,为临床抗感染治疗提供依据。方法采用VITEK 2型全自动微生物检测系统对细菌进行鉴定及药敏分析;用PCR方法检测碳青霉烯酶基因blaOXA-51、blaOXA-23、blaOXA-24和blaOXA-58。结果 2007-2010四年间分离鲍曼不动杆菌811株,耐药率逐年上升,其对头孢哌酮/舒巴坦、美罗培南、头孢吡肟、亚胺培南和哌拉西林/他唑巴坦的耐药率上升明显,如对亚胺培南的耐药率自2007-2010年分别为13.1%、26.0%、44.3%和59.5%。811株鲍曼不动杆菌中IRAB有311株,IRAB对抗生素的耐药率明显升高,但四年间的耐药率变化并不明显。对IRAB敏感的抗生素以阿米卡星为首,其次为头孢哌酮/舒巴坦,但头孢哌酮/舒巴坦的敏感率逐年下降。从311株IRAB中随机抽取140株,检出blaOXA-51基因阳性125株(89.3%),blaOXA-23基因阳性29株(20.7%),blaOXA-24基因阳性3株(2.14%),blaOXA-58基因阳性22株(15.7%)。结论鲍曼不动杆菌的耐药性逐年升高,以阿米卡星与头孢哌酮/舒巴坦联合应用为有效的治疗方法,产碳青霉烯酶是IRAB的主要耐药机制。