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《Chinese Journal of Microecology》 2015-01
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Antimicrobial resistance and quinolone resistance mechanism of Acinetobacter baumannii isolated from urine

WU Li-xin;ZHANG Li-cheng;HONG Zhi-dan;TANG Xiao-ping;Department of Respiratory Medicine,Armed Police Corps Hospital of Zhejiang;Department of Internal Medicine II,Jinhua Pujiang People's Hospital;Department of Respiratory Medicine,the First Affiliated Hospital,Zhejiang University College of Medicine;  
Objective To analyze the clinical features of patients with Acinetobacter baumannii urinary tract infection,the resistance and quinolone resistance mechanism of these isolates. Methods Clinical strains of A. baumannii isolated from urine were collected through January to December,2011 in a hospital of Jiaxing. The clinical features of these patients were retrospectively analyzed. Resistant characteristics of these isolates were also studied.PCR was used to detect the quinolone resistant genes,including qnr A,qnr B,qnr S,qep A,aac( 6')-Ib-cr,gyr A and par C. Sequence analysis was performed to confirm the resistant genes. Results A total of 53 A. baumannii were isolated,among which 88. 7% were from patients in ICU or surgery department,and 99. 3% were from patients indwelled urethral catheter. The removal of urethral catheter and appropriate antibiotics resulted in good outcomes. These strains were highly resistant to most of Penicillins,Cephamycins,Extended-spectrum Cephalosporins,Carbapenems,Monobactams,Quinolones and Aminoglycosides. The resistance rates to Cefoperazone / sulbactam,Minocycline,Amikacin,Meropenem,Imipenem,Ampicillin / sulbactam and Ciprofloxacin were 15. 1%,20. 8%,22. 6%,26. 4%,28. 3%,32. 1% and 47. 1%,respectively. Among the 25 Ciprofloxacin-resistant isolates,mutations of gyr A and par C genes were detected in 17 and 12 strains,respectively. One isolate harbored qnr B gene; no qep A gene was found. Seven isolates harbored aac( 6')-Ib gene,but no aac( 6')-Ib-cr mutation was detected. Conclusion A. baumannii is mostly isolated from inpatients indwelled urethral catheter. These strains are highly resistant to most of antimicrobial agents,treatment including urethral catheter removal and appropriate antibiotics resulted in good outcomes. The resistance to quinolones is mainly caused by mutation of gyr A or par C,and qnr B gene occurred in one isolate.
【CateGory Index】: R446.5
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