膜孔蛋白改变在鲍曼不动杆菌对亚胺培南耐药中的作用

目的 对鲍曼不动杆菌耐药情况进行分析，探索膜孔蛋白在亚胺培南耐药中的作用，为临床合理用药及控制医院感染提供依据。方法 收集非重复亚胺培南耐药鲍曼不动杆菌63株，亚胺培南敏感鲍曼不动杆菌21株，用K-B纸片法检测上述细菌对16种抗菌药物的敏感性，PCR技术检测carO和oprD膜孔蛋白基因携带情况，并采用DNASTAR软件进行序列对比，对CarO蛋白三维结构建模。结果 亚胺培南耐药鲍曼不动杆菌除对替加环素（3.2%）、头孢哌酮/舒巴坦（28.6%）和米诺环素（30.2%）耐药率低外，对其他抗菌药物耐药率均较高，而亚胺培南敏感菌对多数抗生素均较敏感。PCR扩增显示所检测菌株carO和oprD基因均阳性。进一步系列比对发现亚胺培南耐药株较敏感株carO基因存在有意义突变，蛋白质分子立体结构有明显差别。结论 亚胺培南耐药鲍曼不动杆菌耐药情况严峻，carO膜孔蛋白基因突变发挥重要作用。

Role of porin changes in Imipenem resistance of Acinetobacter baumannii

Objective To analyze the drug resistance of Acinetobacter baumannii, explore the role of membrane porin in its resistance to Imipenem and provide a basis for clinical rational use of drugs and control of nosocomial infections. Methods 63 isolates of Imipenem resistant Acinetobacter baumannii (IRAB) and 21 isolates of Imipenem sensitive Acinetobacter baumannii (ISAB) were collected. The sensitivities to 16 antimicrobial agents were detected with K-B method. PCR technique was used to detect the carO and oprD genes, and the DNASTAR software was used to compare the sequence of CarO protein. Three-dimensional structure model of CarO protein was established. Results The resistance rates of IRAB to most antibiotics were high except those to Tigecycline (3.2%), Cefoperazone/Sulbactam (28.6%) and Minocycline (30.2%). ISAB was sensitive to most antibiotics. PCR amplification showed that all the tested strains were both carO- and oprD-positive. Further series comparison showed that there was a significant mutation in the carO gene in IRAB and a significant difference in the three-dimensional structure of the protein molecule between IRAB and ISAB. Conclusion The drug resistance of IRAB is high; the mutation of carO gene plays an important role in the resistance to Imipenem.