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中文摘要：
目的了解临床分离的鲍氏不动杆菌泛耐药株（PDRABA）β-内酰胺类、氨基糖苷类、喹诺酮类、氯霉素、四环素、利福平和磺胺类等7类抗菌药物耐药基因及多种药物外排泵基因和质粒、转座子、整合子遗传标记存在状况。方法采用K—B纸片扩散法测定22种抗菌药物的敏感性，并用聚合酶链反应（PCR）及序列分析的方法检测β-内酰胺酶基因、氨基糖苷类耐药基因（包括氨基糖苷类修饰酶基因、16S rRNA甲基化酶基因）、gyrA突变喹诺酮耐药基因、利福平耐药相关基因、四环素耐药相关基因、氯霉素耐药相关基因、磺胺耐药相关基因、多种药物外排泵基因、质粒遗传标记、转座子遗传标记和整合子遗传标记等73种耐药基因及遗传标记。结果该PDRABA除对头孢哌酮／舒巴坦敏感以外，其余21种抗菌药物均为耐药，共检出TEM、OXA-23、ADC、aac（3）-I、aac（6＇）-Ib、ant（3＇＇）-I、aph（3＇）-I、tetB、mdfA、qacE△1-sul1、intI1、tnpU、tnp513、ISabal、gyrA突变等15种耐药基因及遗传标记，其余58种基因均阴性。结论携带多种耐药基因和多种药物外排泵基因mdfA是该菌株泛耐药的成因，同时该PDRABA株携带多种可移动遗传元件，极易造成耐药基因的水平转移，对PDRABA感染者应实行严格的隔离措施，同时携带TEM、OXA-23、ADC、aac（3）-I、aac（6＇）-Ib、ant（3＇＇）-I、aph（3＇）-I、tetB、mdfA、qacE△1-sul1、intI1、tnpU、tnp513、ISabal基因伴喹诺酮作用靶位gyrA基因突变为国内首次报道。
英文摘要：
OBJECTIVE To investigate the distribution of genes resistant to 7 kinds of antimicrobial agents： betalactams, aminogtycosides, quinolones, chloramphenicol, tetracycline, rifampicin, trimethoprim/sulfamethoxazole, and drug efflux genes, as well as genetic markers of conjugal plasmids, transposons and integrons in a strain of pan-drug resistant Acinetobacter baumannii （PDRABA） isolated from clinical sample. METHODS Drug susceptibility tests to 22 kinds of antimicrobial agents were detected by K-B disk diffusion tests. Then, 73 kinds of resistant genes and genetic markers were analyzed by PCR and verified by DNA sequencing, including resistant genes to beta-lactams, resistant genes to aminoglycosides （aminoglycoside modifying enzyme genes and 16S rRNA methylase genes）, resistant gene to quinolones of gyrA mutation, resistant genes to chloramphenicol, resistant genes to tetracycline, resistant genes to rifampicin, resistant genes to trimethoprim/sulfamethoxazole, and drug efflux genes, as well as genetic markers of conjugal plasmids, genetic markers of transposons, and genetic markers of integrons. RESULTS The strain of PDRABA was susceptible to cefoperazone/sulbactam, but resistant to other 21 kinds of antimicrobial agents. And 15 kinds of resistant genes and genetic markers were detected out： TEM, OXA-23, ADC, aac（3）-I, aae（6＇）-I b, ant（3＇＇）-I , aph（3＇）-I , tetB, mdfA, qacE△1-sul1, int I 1, tnpU, tnp513, ISabal, and gyrA mutation. However, the rest 58 kinds of genes and genetic markers couldn＇t be detected out. CONCLUSIONS The pan-drug resistance resulted from some kinds of resistant genes and genetic markers as well as drug efflux gene mdfA harboring on it. Furthermore, some kinds of mobile genetic elements harboring on the strain are prone to lead to horizontal dissemination of resistant genes and genetic markers. Thus, strict isolation measures should be enforced to patients infected with the strain of PDRABA. And it＇s the first report that a strain harbors resistant gen
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