利用多重引子聚合酶連鎖反應分析碳醯胺基抗藥性鮑氏不動桿菌

Multiplex polymerase chain reaction for detection of carbapenem resistant Acinetobacter baumannii

王雅琳(Ya-Lin Wang)

指導教授 ： 蔡淦仁

中山醫學大學/醫學院/生化暨生物科技研究所/碩士(2012年)

摘要

鮑氏不動桿菌（Acinetobacter baumannii）為院內感染常見的伺機性菌株。近年來許多醫院的鮑氏不動桿菌群突發分析，皆與對碳醯胺基（Carbapenem）類抗生素產生碳醘胺基酶抗藥性有關，在過去研究中產生碳醘胺基酶的基因，OXA-type基因是碳醘胺基抗藥性鮑氏不動桿菌（Carbapenem resistant Acinetobacter baumannii, CRAB）菌株中最常被發現的，所以本研究的目的是要調查OXA type基因分型結果與分佈情形，及OXA type基因分型結果與碳醘胺基抗藥性鮑氏不動桿菌間相關性，期待建立快速鑑定碳醘胺基抗藥性鮑氏不動桿菌的分子檢測方式。本研究收集二個批次鮑氏不動桿菌，第一批次為31株從痰液分離的碳醘胺基抗藥性鮑氏不動桿菌；第二批次為60株不分檢體來源及碳醘胺基抗生素感受性試驗結果的鮑氏不動桿菌，將二批次鮑氏不動桿菌，使用OXA-23-like 、 OXA-24-like、OXA-51-like及OXA-58-like primer進行多重引子聚合酶連鎖反應分析（Multiplex polymerase chain reaction）及資料分析。第一批次菌株的實驗結果共有30株菌株同時帶有OXA-51-like與OXA-23-like基因，1株同時帶有OXA-51-like與OXA-24-like基因；在第二批次菌株的實驗結果共有40株帶有OXA-51-like基因，其中25株同時帶有OXA-23-like基因，2株帶有OXA-24-like基因。綜合二個批次，共有55株碳醘胺基抗藥性鮑氏不動桿菌，其中有53株帶有OXA-23-like基因，說明OXA-23-like基因的存在與碳醘胺基抗藥性鮑氏不動桿菌具有相關性（P value < 0.05），未來可做為用藥選擇及治療方式之參考。

關鍵字

碳醯胺基抗藥性鮑氏不動桿菌

並列摘要

Acinetobacter baumannii is one of the common opportunistic strains of nosocomial infections. In recent years, the outbreaks of Carbapenem resistant A. baumannii in many hospitals are frequently associated with the production of Carbapenemases carried by OXA gene in these resistant strains. In this study, OXA genotyping was performed and evaluated its clinical preference among Carbapenem resistant A. baumannii. The A. baumannii from two different periods of time were collected and prepared for multiplex polymerase chain reaction using the OXA-23-like, OXA24-like, OXA-51-like, OXA-58-like Carbapenemases primers. Our results indicated that, among the first 31 isolations, there are 30 of them displayed OXA-51-like and OXA-23-like genes and only one carried OXA-51-like and OXA-24-like genes. Another experiment from different isolations has found that 40 carried OXA-51-like gene, including 25 of them also carried OXA-23-like gene and 2 has OXA-24-like gene. In this study, we have identified 55 Carbapenem resistant A. baumannii carried OXA-51-like gene and 53 of them also displayed OXA-23-like gene. A correlation between Carbapenem resistant A. baumannii and OXA-23-like gene positive was then established (P < 0.05). Together, it is suggested that multiplex PCR using OXA-51-like and OXA-23-like genes as detection targets would be able to serve as indicator for Carbapenem resistant in A. baumannii.

並列關鍵字

carbapenem resistant Acinetobacter baumannii

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