Mechanism Of 35 Strains MDR-AB Integron And FIC Of Minocycline Combined With 10 Antibiotics Of Study

ObjectiveTo explore the sensitivity of minocycline combined with 10 antibiotics to multidrug resistant Acinetobacter baumannii(MDR-AB),to find out the best combination scheme,to provide a reference for clinical treatment of multidrug resistant Acinetobacter baumannii infection,and to detect the type of integron carried by MDR-AB.Explore whether integron is associated with multidrug resistant Acinetobacter baumannii resistance.Methods35 strains of non-repetitive multidrug resistant Acinetobacter baumannii isolated from the clinical specimen of the First Affiliated Hospital of Jinzhou Medical University from August 2016 to August 2017 were selected,the determination of 11 kinds of antibiotics,including minocycline minimum bacteriostatic concentration(MIC),and the determination of minocycline and 10 kinds of antibiotics combination classification bacteriostatic concentration index(FIC),the DNA of multidrug resistant Acinetobacter baumannii was extracted,the primers were designed and amplified,the electrophoretic results of the amplified products were recorded,and the positive products were tested for gene sequencing.Results1.Minocycline was combined with levofloxacin,cefoperazone/sulbactam,sulbactam,polymyxin B,and the minimum bacteriostatic concentration of 90%(MIC90)was reduced to 1/2,the MIC90 remains unchanged after the combination with meropenem and piperacillin/sulbactam,in combination with etimicin sulfate,amikacin,gentamicin and fosfomycin,MIC90 rose to the original 2 times.2.10 antibiotics combined with minocycline: sulbactam compared with the single drug,MIC90 reduced to 1/16,cefoperazone/sulbactam,polymyxin B and piperacillin/ sulbactam compared with the single drug,MIC90 reduced to 1/8,levofloxacin compared with the single drug,MIC90 reduced to 1/4,meropenem compared with the single drug,MIC90 reduced to 1/2,etimicin sulfate,amikacin,gentamicin and fosfomycin compared with the single drug,MIC90 rose to the original 2 times.3.After the combination of minocycline and polymyxin B,levofloxacin,sulbactam,cefoperazone / sulbactam,the FICs were mainly in the range of less than 1,mainly showed synergistic and additive effect,after the combination of minocycline and meropenem,piperacillin/sulbactam,the FICs were mainly in the range of 0.5 to 2,mainly showed additive and uncorrelated effect,after the combination of minocycline and etimicin sulfate,amikacin,gentamicin,fosfomycin,the FICs were mainly in a range greater than 2,mainly showed antagonism.4.Among the 35 strains of multidrug resistant Acinetobacter baumannii,18 strains carried class I integron,the positive rate was 51.4%,and 15 strains carried variable region of integron,the positive rate was 42.9%.The drug resistance rate of levofloxacin in class ?integron positive strains was 38.9%,and the drug resistance rate of negative strains was 0,suggesting that class I integron positive strains may have an effect on levofloxacin resistance.Conclusions1.The combination of minocycline and polymyxin B was the best,followed by levofloxacin,sulbactam,cefoperazone/sulbactam,the combination of minocycline and etimicin sulfate,amikacin,gentamycin and fosfomycin mainly showed antagonism.2.The type of integron carried by 35 strains of Multidrug resistant Acinetobacter baumannii was mainly class I integron,and Class I integron may be associated with levofloxacin resistance...