中文摘要：

目的探讨临床分离鲍氏不动杆菌主动外排基因adeFGH的表达与其多药耐药的关系。方法对2012年1-2月临床分离的60株鲍氏不动杆菌进行回顾性分析,采用BD CRYSTAL细菌鉴定系统进行细菌检测,采用法国生物梅里埃公司ATB药敏系统进行药物敏感试验,PCR检测外排泵基因adeFGH的分布和表达水平。结果痰液及伤口分泌物中分别检出鲍氏不动杆菌51及8株,分别占85.0%、13.3%;科室分布主要为ICU、神经外科、呼吸内科、烧伤科,分别占43.3%、28.3%、10.0%、10.0%;60株鲍氏不动杆菌按药敏结果分为A组全耐药共31株,B组为氨基糖苷类和磺胺甲噁唑/甲氧苄啶敏感、其他抗菌药物耐药共13株,C组为耐阿莫西林和一、二代头孢菌素类抗菌药物、其他抗菌药物敏感,共16株;A组均检出外排泵基因adeFGH,B组均检出外排泵基因adeFGH,C组检出外排泵基因adeG16株、adeH3株,未检出adeF。结论外排泵基因adeFGH与鲍氏不动杆菌对氨基糖苷类和磺胺甲噁唑/甲氧苄啶的耐药无关,外排泵基因adeG与鲍氏不动杆菌对青霉素类和一、二代头孢菌素类抗菌药物耐药有关。

英文摘要：

OBJECTIVE To explore the relationship between multidrug resistance with the expression of active efflux gene adeFGH of Acinetobacter baumannii.METHODS Totally 60 strains of A.baumannii separated in clinical were retrospectively analyzed from Jan 2012 to Feb 2012.The BD CRYSTAL bacteria identification system was used for bacteria detection,the biological merry Emmanuel France ATB susceptibility system was used for drug sensitive test,the expression level and distribution of active efflux gene adeFGH was detected by PCR.RESULTS The A.baumannii in sputum and wound secretion were detected 51 and 8strains respectively,accounted for 85.0% and 13.3% respectively.The main department was the ICU,neurosurgery,respiratory medicine and burn department,accounting for 43.3%,28.3%,10.0% and 43.3% respectively.These strains were divided into three groups based on the susceptibilities：group A（31strains,resistant to all the drugs）,group B（13strains,sensitive to aminoglycosides and sulfamethoxazole-trimethoprim,resistant to the other antibacterial agents）,group C（16 strains,resistant to amoxicillin and the first or second generation cephalosporins,sensitive to the other antibacterial agents）.The active efflux pump gene adeFGH were detected from group A and group B;the adeGwas detected in 16 strains in the group C,adeHin 3strains,and adeFwas not detected.CONCLUSIONThe active efflux system of adeFGHis irrelevant to the resistance of A.baumannii to aminoglycosides and sulfamethoxazole-trimethoprim,the active efflux system of adeGis relevant to the resistance of A.baumannii to moxicillin and the first or second generation cephalosporins.