Objective To analyze the correlation between the clinical cases of the ICU and the environment, and to explore the characteristics of drug resistance genes carried by multidrug resistant Acinetobacter baumannii and its approach to transmit drug resistance genes.
Methods The results of sequencing were analyzed by susceptibility test microdilution method MIC and polymerase chain reaction amplification.Some positive genes were sequenced.
ResultsFrom March 2013 to March 2014, ICU cliamynical samples were used to isolate 150 strains of cephalosporins, aminoglycoside antibiotics, gentamycin, whose drugs resistance rate were above 96.00%.The resistant rate of 105 strains of Acinetobacter baumannii to aminoglycoside antimicrobial amikacin was up to 62.39%.The resistance rate to carbapenem antibiotics (imipenem, meropenem) was 53.21%, 55.96%.Analysis of drug resistance genes in clinical cases and environmental specimens showed that the active efflux pump adBe gene was expressed with the A, D-type β-lactamase or class A, C-β-lactamase gene, membrane porin carO Gene, aminoglycoside gene and so on.The expression of carO gene was correlated with aminoglycoside gene aph(3′)-Ι, aac(6′)-Ⅰb, D-type β-lactamase OXA-51, 66 group and cyclophosphate gyrA gene.There was a mutation in one of the gryA gene sequences of the isolates of the genus Acinetobacter.
Conclusion It is proved that Acindetobacter baumannii carrying adBe gene plays an important role in producing multi-drug resistance in commonly used antibacterials. Membrane pore protein carO high expression, mediating penicillin penetration, is involved in multiple drug resistance to Acinetobacter baumannii.Therefore, we must beware of the emergence of subtypes of new drug resistance genes and strengthen the ward environment disinfection and management, that is an effective way to block the transmission of ICU multi-drug resistant Acinetobacter baumannii.
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