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中文摘要：
目的 探讨主动外排系统在多药耐药鲍氏不动杆菌耐药中的机制,为临床研制新型抗菌药物提供实验数据。方法 收集临床分离多药耐药鲍氏不动杆菌96株,采用微量肉汤稀释法测定5种抗菌药物对实验菌株的最低抑菌浓度（MIC）;并同时测定加入羰基氰氯苯腙（CCCP）泵抑制剂后抗菌药物的MIC,以加入泵抑制剂后MIC值降低至原值的1/4及以下判为外排泵表型阳性;并使用PCR方法对外排泵基因adeB、adeR、adeS、adeG、adeJ进行检测。结果 5种抗菌药物的MIC50、MIC90均属耐药水平;加入泵抑制后,抗菌药物MIC50、MIC90均有下降,美罗培南的MIC50降至中介水平,其余MIC50、MIC90均属耐药水平;以庆大霉素为外排底物检出外排泵表型阳性率为84.4%,显著高于其他药物为外排底物检出阳性率（P〈0.05）;外排泵表型阳性菌adeB、adeR、adeS、adeG、adeJ基因的检出率均显著高于外排泵表型阴性菌（P〈0.05）;对adeB、adeR、adeS、adeG、adeJ基因进行测序,所测序列与GenBank中序列同源性为100%。结论 药物主动外排是鲍氏不动杆菌多药耐药的重要因素之一。
英文摘要：
OBJECTIVE To explore the mechanism of efflux pumps in multidrug-resistant Acinetobacter baumannii so as to provide laboratory data for clinical development of novel antibiotics. METHODS A total of 96 clinical multi- drug-resistant A. baumannii isolates were collected, then the minimum inhibitory concentrations （MICs） of 5 types of antibiotics against the experimental strains were determined by using micro-broth dilution method, meanwhile, the MICs of the antibiotics were determined after the carbonyl cyanide m-chlorophenylhydrazone （CCCP） pump in- hibitors were added, the selection criteria of the positive phenotype of efflux pump was that the MICs declined to less than a quarter of the original value after the pump inhibitors were added, and the efflux pump genes, including adeB, adeR, adeS, adeG, and adeJ , were detected with the use of PCR. RESULTS The MICs0 and MICg0 of the 5 types of antibiotics were at the drug resistance levels; after the pump inhibitors were added, the MIC50 and MIC50 of the antibiotics declined, the MIC50 of meropenem declined to the drug intermediary level, and the MIC50 and MIC50 belonged to the drug resistance level. The positive rate of efflux pump phenotype for which gentamicin was used as efflux pump substrate, significantly higher than that of the efflux pump phenotypes for which other antibiotics were used as the efflux pump substrates （P〈0.05）. The positive rates of detection of adeB, adeR, adeS, adeG, and adeJ genes were significantly higher in the efflux pump phonotype-positive strains than in the ef- flux pump phonotype-negative strains （P〈0.05）. The adeB, adeR, adeS, adeG, and adeJ genes were se- quenced; the homology between the detected sequences and the GenBank sequences was 100 %. CONCLUSION The active efflux of drugs is one of important multidrug-resistant mechanisms of the A. baumannii strains.
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