耐亚胺培南铜绿假单胞菌β-内酰胺酶研究  

Study on the β-lactamases in imipenem-resistant Pseudomonas aeruginosa

作　　者：王杰[1] 周建英[1] 俞云 

机构地区：[1]浙江大学医学院附属第一医院呼吸内科,杭州310003 [2]浙江大学医学院附属第一医院传染科,杭州310003

出　　处：《浙江医学》2005年第11期818-821,共4页Zhejiang Medical Journal

基　　金：浙江省科技厅重点项目(011103717);浙江省科学技术厅重点项目(2004c23011)

摘　　要：目的分析临床分离的27株耐亚胺培南铜绿假单胞菌的耐药性及β-内酰胺酶的类型。方法采用K-B法测定美罗培南等15种抗菌药物对27株铜绿假单胞菌的体外抗菌活性;三维试验、2-巯基丙酸抑制试验、聚合酶链反应(PCR)分析β-内酰胺酶类型。结果阿米卡星敏感性最高为66.7%,其它依次为头孢哌酮/舒巴坦(55.6%)、头孢吡肟(51.9%),美罗培南敏感率为29.6%。三维试验结果表明,12株产碳青霉烯酶中金属酶2株;单产AmpC酶3株。2-巯基丙酸抑制试验筛选金属酶2株阳性,与三维试验结果相符。根据参考文献设计VIM-2特异性引物,PCR反应结果阳性,经克隆测序证实VIM-2型金属酶。结论我院铜绿假单胞菌对亚胺培南耐药机制中很重要一部分原因是产碳青霉烯酶。Objective To analyze the resistance and β-lactamases of 27 imipenem-resistant Pseudomonas aeruginosa. Methods Antimicrobial activity to 27 imipenem-resistant Pseudomonas aeruginosa were determined by K-B test, and the β-lactamases produced by these strains were characterized by three-dimensional test, 2-mercaptopropanoic acid inhibited assays, and polymerase chain reaction （PCR）. Results The susceptibility rates to amikacin ,cefoperazone/sulbactam ,cefepime were 66.7%.55.6%,51.9%,respectively. The resistance rate of meropenem was 29.6%, Three-dimensional test indicated 12 strains produced carbapenemases, only 2 strain produced metallo-β-lactamase, which was in agreement with the result of 2-mercaptopropanoic acid inhibited assays, 3 strains produced AmpC enzymes. The 2 metallo-β-lactamase showed the amplified PCR products with VIM-2 specific PCR, the production was sequenced and revealed that the nucleotide sequences matched nearly exactly with the known sequences of VIM-2. Conclusion The production of carbapenemases was the main mechanisms for carbapenem resistance in Pseudomonas aeruginosa in our hospital.

关 键 词：铜绿假单胞菌 耐药性 Β-内酰胺酶 亚胺培南 体外抗菌活性 

分 类 号：R446.5[医药卫生—诊断学]