耐碳青霉烯类抗生素铜绿假单胞菌协同阴性菌耐药机制的研究  

Resistance mechanisms to carbapenems in Pseudomonas aeruginosa with negative synergy test

作　　者：明德松[1] 吴一波[1] 朱焱[1] 谢尊金[1] 

机构地区：[1]福建省泉州市第一医院检验科,福建泉州362000

出　　处：《世界感染杂志》2005年第4期322-323,共2页World Journal of Infection

摘　　要：目的研究协同阴性的铜绿假单胞菌（PA）耐碳青霉烯类抗菌药物机制。方法应用多底物一多抑制剂协同法检测39株耐碳青霉烯类抗菌药物PA临床分离株，推测其耐药机制并分析其分布情况。结果在本组菌，存在5种表型，头孢他啶敏感／亚胺培南耐药／美罗培南耐药、头孢他啶敏感，亚胺培南耐药，美罗培南敏感、头孢他啶耐药，亚胺培南耐药，美罗培南耐药、头孢他啶敏感，亚胺培南耐药，美罗培南中介、头孢他啶耐药，亚胺培南耐药，美罗培南敏感，其耐药机制及分布分别为不明机制23株（59．0％）、单纯D2缺乏8株（20．5％）、AB泵＋D2缺乏4株（10．3％）、EF泵＋D2缺乏3株（7．7％）、AmpC酶＋D2缺乏1株（2．6％）。结论PA至少存在5种表型，D2缺乏是主要机制之一，且多为多重机制；部分菌耐药机制需进一步研究。Objective To study resistance mechanisms in Pseudomonas aeruginosa （PA） to carbapenems with negative synergy test. Methods A total of 39 carbapenem-resistant PA isolates were detected by a multi disk-multi inhibitor synergy test （MDMIST）; the resistance mechanisms based on the phenotypes from MDMIST were presumed and the distribution of resistance mechanisms analyzed. Results Five resistance phenotypes of these 39 PA isolates were unveiled： ceftazidime-susceptible （S）/imipenem-resistant （R）/ meropenem-R, ceftazidime-S/imipenem-R/meropenem-S, ceftazidime-R/imipenem-R/meropenem-R, ceftazidime-S/imipenem-R/meropenem-intermediate, and ceftazidime-R/imipenem-R/meropenem-S. Resistance mechanisms included 23 （59.0%） unknowns, 8 （20.5%） single D2-deficiency, 4 （10.3%） AB efflux plus D2-deficiencies, 3 （7.7%） EF efflux plus D2-deficiencies, and 1 （2.6%） AmpC plus D2-deficiencies. Conclusions There are at least 5 drug resistance phenotypes in PA and it is common to have multiple phenotypes existed single PA isolate. The D2-deficiency is most common resistance mechanism identified while over half of the carbapenem-resistant PA isolates remain unknown for their resistance mechanisms.

关 键 词：铜绿假单胞菌 D2通道 外排泵 

分 类 号：R378.991[医药卫生—病原生物学]