诊断学理论与实践

诊断学理论与实践 >

2025 , Vol. 24 >Issue 06: 621 - 627

DOI: https://doi.org/10.16150/j.1671-2870.2025.06.007

论著

2023年至2024年新疆某三甲医院耐碳青霉烯类鲍曼不动杆菌的耐药性研究

  • 贾丽影 ,
  • 许海峰 ,
  • 于冲 ,
  • 郭万海 ,
  • 龙锐
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  • 克拉玛依市中心医院临床检验中心， 新疆维吾尔自治区 克拉玛依市 834000
龙锐 E-mail：1107417401@qq.com

收稿日期: 2025-04-19

  修回日期: 2025-06-24

  网络出版日期: 2025-12-25

基金资助

克拉玛依市中心医院青年科学基金项目(QK2023-3)

收起

Study on drug resistance of carbapenem-resistant Acinetobacter baumannii in a tertiary hospital in Xinjiang from 2023 to 2024

  • JIA Liying ,
  • XU Haifeng ,
  • YU Chong ,
  • GUO Wanhai ,
  • LONG Rui
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  • Clinical Laboratory Center, Karamay Central Hospital, Xinjiang Karamay 834000, China

Received date: 2025-04-19

  Revised date: 2025-06-24

  Online published: 2025-12-25

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摘要

目的： 分析克拉玛依市中心医院2023年至2024年耐碳青霉烯类鲍曼不动杆菌（carbapenem resistant Acinetobacter baumannii，CRABA）的分子流行病学特征，了解CRABA碳青霉烯酶和耐药节结细胞分化家族[resistance-nodulation-cell division （family），RND]外排泵基因的携带情况，为新疆地区临床防控和治疗鲍曼不动杆菌感染提供实验依据。方法： 收集2023年至2024年克拉玛依市中心医院临床培养分离出的CRABA，计算鲍曼不动杆菌中检出CRABA的百分比（检出率）；采用PCR技术检测10种常见的碳青霉烯酶基因和RND外排泵基因。结果： 本研究检出179株CRABA，检出率为79.56%，主要检出科室为ICU（62.60%）和呼吸重症监护室（11.73%）。179株CRABA对抗菌药物的耐药率均较高，其中对环丙沙星的耐药率最高（100%），而对替加环素的耐药率最低（11.73%）。耐药基因检测结果显示，179株CRABA中阳性基因携带率从高到低分别为blaIMP 95.53%（171/179）、blaOXA-51 87.71%（157/179）、blaTEM 82.12%（147/179）、adeB 82.12%（147/179）、adeM 80.45%（144/179）、adeJ 77.65%（139/179）、blaOXA-23 74.86%（134/179）、blaNDM-1 8.94%（16/179）、blaOXA-58 4.47%（8/179）、blaVIM 0（0/179）。结论： 2023年至2024年，我院CRABA检出率高于全国平均水平（2023年，73.4%）；碳青霉烯酶基因blaIMP、blaTEM及RND外排泵基因adeB、adeM、adeJ的高表达，提示本地区临床应加强抗菌药物的管理，合理使用抗菌药物。

关键词： 耐碳青霉烯类鲍曼不动杆菌; 碳青霉烯酶; RND外排泵基因

本文引用格式

贾丽影 , 许海峰 , 于冲 , 郭万海 , 龙锐 . 2023年至2024年新疆某三甲医院耐碳青霉烯类鲍曼不动杆菌的耐药性研究[J]. 诊断学理论与实践, 2025 , 24(06) : 621 -627 . DOI: 10.16150/j.1671-2870.2025.06.007

Abstract

Objective To analyze the molecular epidemiological characteristics of carbapenem-resistant Acinetobacter baumannii (CRABA) at Karamay Central Hospital from 2023 to 2024, and to investigate the carriage of carbape-nemase and RND efflux pump genes in CRABA, so as to provide an experimental basis for the clinical prevention, control, and treatment of Acinetobacter baumannii infection in the Xinjiang region. Methods CRABA strains isolated from clinical culture at Karamay Central Hospital from 2023 to 2024 were collected, and percentage of CRABA detected in Acinetobacter baumannii (detection rate) was calculated. PCR was used to detect 10 common carbapenemase genes and RND efflux pump genes. Results A total of 179 CRABA strains were obtained with a detection rate of 79.56%. The majority were detected in the ICU (62.60%) and the respiratory intensive care unit (11.73%). The strains showed high resistance rate to antibiotics, with the highest resistance rate observed for ciprofloxacin (100%), and the lowest for tigecycline (11.73%). The detection of drug resistance genes revealed that among the 179 CRABA strains, the positive carriage rates from high to low were: blaIMP 95.53% (171/179), blaOXA-51 87.71% (157/179), blaTEM 82.12% (147/179), adeB 82.12% (147/179), adeM 80.45% (144/179), adeJ 77.65% (139/179), blaOXA-23 74.86% (134/179), blaNDM-1 8.94% (16/179), blaOXA-58 4.47% (8/179), and blaVIM 0 (0/179). Conclusions The detection rate of CRABA at our hospital from 2023 to 2024 were significantly higher than the national average (2023, 73.4%). The high expression of the carbapenemase genes include blaIMP and blaTEM, and RND efflux pump genes adeB, adeM, and adeJ. This suggests that local clinical practice should strengthen the management of antibiotics and ensure their rational use.

Key words： Carbapenem-resistant Acinetobacter baumannii; Carbapenemase; RND efflux pump genes

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