A Study On Carbapenem-resistant Acinetobacter Adeabc Drug Efflux Pumps And Its Homology Analysis Of Hospital Infection Application

Objective To investigate the Ningxia Medical University General Hospital ICU wardAcinetobacter spp specimen types, clinical features distribution, resistance phenotype,AdeABC efflux pump genotype, carbapenem-resistant genotypes, and their homology toobtain hospital ICU infections Acinetobacter spp resistant important data trends and molecularepidemiology, clinical microbiology diagnostics, antibiotics provide effective guidance interms of scientific and rational use of clinical prevention of nosocomial infectionsurveillance.Methods Establish strains collected in our hospital from September2005thelibrary. since January2012to December2012in ICU clinical specimens infected isolatedAcinetobacter spp were102, of which nine sensitive strains of bacteria were isolated andcultured according to the "National clinical Laboratory Practice "(3rd edition) carried out bythe French Merieux automated microbiological analyzer (VITEK2COMPACT)identification. Carried KB method to detect bacteria on14kinds of antibiotic resistance, andresistance to the use of WHONET5.5software analyze the results; re-use drug efflux pumpinhibitors table testing. PCR techniques were used to detect carbapenemase production-relatedresistance gene type OXA-51, OXA-23, OXA-24, OXA-58, VIM, IMP-1, IMP-4, SIM,NDM-1; AdeABC drugs outside efflux pump genes AdeA, AdeB, AdeC and regulate geneAdeS, AdeR; finally pulsed-field gel electrophoresis (PFGE) analysis of its clonal spread.Results Since January1,2012to December30,2012in our hospital infections in ICU clinicalspecimens isolated Acinetobacter spp Total102: Most patients aged over60years old,42cases, accounting for41.17%; than40years old36patients less than60years old,accounting for35.29%; than20years of age less than40years of age in18patients,accounting for17.64%: fewer children and young people infected with Acinetobacter spp, more than2years in patients less than19years old were four cases, accounting for3.92%infants less than1year old2cases, accounting for1.96percent. Male patients78cases, accounting for76.47%;24cases of female patients. Infected specimens mainly fromrespiratory specimens of72accounted for70.5%.102drug resistance rate Acinetobacter spp:Cefotetan and cotrimoxazole reached100%, followed by aztreonam resistance rate of99.3%;ampicillin/sulbactam, ticarcillin/ct Victoria acid, ceftazidime, ceftriaxone andcefepime resistance rates higher than90%. Imipenem and polymyxin B resistance rates arerelatively low, respectively,81.6%and12.5%. Other drugs are also between85%to90%.After adding efflux pump inhibitors,102Acinetobacter baumannii to three classes ofantibiotics MIC50, MIC90were decreased.102Acinetobacter spp five kinds AdeABC effluxpump resistance gene positive rate greater than71.0%, AdeA, AdeB, AdeC three genes weredetected in73strains positive detection rate reached71.5percent, more than five genes weredetected in68strains positive detection rate of66.7%;93multi-drug resistant strains, alldetected carrying OXA-23, OXA-51gene, OXA-24, OXA-58, VIM, IMP-1, IMP-4, SIM,NDM-1resistance gene in these wholly negative.102Acinetobacter spp divided into nineclone type, in which the predominant clone type is A, B, C, D, E five clone-type, and theremaining four clones sporadic type strain, considered epidemic strains A, B, C, D, E is notrelevant. Conclusions Acinetobacter baumannii to various antimicrobial drug resistance stillon an upward trend, imipenem against Acinetobacter spp still has good in vitro antibacterialactivity. Active efflux mechanism in the hospital ICU ward detected Acinetobacter sppmultiple drug resistance plays an important role. ICU ward detected Acinetobacter spp,OXA-23and OXA-51genes are the main causes of resistance to carbapenems. AdeABCefflux pump genes exist in much higher detection rate of resistant strains susceptible strains,efflux pump gene expression and Acinetobacter spp multi-drug-related sexual relations, andits spread primarily through gene cloning disseminated to spread. Our hospital ICU wardmulti-drug resistant Acinetobacter spp strain detection rate is high, and has a high homology,suggesting that we should strengthen the detection of bacterial resistance, reasonable standardantibiotics, thus preventing hospital infection epidemic occur.