医院感染铜绿假单胞菌对抗菌药物多重耐药基因的研究  

Genic analysis of multidrug resistant Pseudomonas aeruginosa in nosocomial infection

作　　者：王继东[1] 王晓岚[2] 周丽珍[1] 宫玲玲[1] 唐丽凤[1] 郁敏[1] 糜祖煌[3] 

机构地区：[1]江南大学附属医院,江苏无锡214073 [2]江南大学医学系,江苏无锡214064 [3]无锡市克隆遗传技术研究所,江苏无锡214026

出　　处：《中国感染控制杂志》2007年第2期77-82,共6页Chinese Journal of Infection Control

摘　　要：目的了解某院铜绿假单胞菌(PA)医院感染菌株的多重耐药情况和有关机制。方法采用微量肉汤法对分离自临床标本的37株PA进行药敏试验;应用聚合酶链反应(PCR)法对多重耐药的PA进行β-内酰胺酶基因、氨基糖苷类修饰酶基因、耐消毒剂和磺胺基因检测,并对耐药基因进行测序。结果β-内酰胺酶基因TEM、CARB、VIM的阳性率分别为24.32%(9/37)、43.24%(16/37)、5.41%(2/37),而SHV、CTX-M、OXA-10group、PER、GES、VEB、DHA、IMP均阴性,oprD2缺失率为86.49%(32/37);氨基糖苷类修饰酶基因aac(6′)-Ⅰ、aac(6′)-Ⅱ、ant(3″)-Ⅰ和ant(2″)-Ⅰ阳性率分别为8.11%(3/37)、43.24%(16/37)、18.92%(7/37)、40.54%(15/37);耐消毒剂和磺胺基因qacE△1-sul1阳性达51.35%(19/37)。结论医院感染PA存在多种耐药基因,严重影响临床的抗感染疗效,应采取有效措施控制耐药菌株的出现。Objective To investigate the multidrug resistance and resistant mechanisms of Pseudomonas aerugino sa in nosocomial infection. Methods Thirty-seven strains of Pseudomonas aeruginosa were performed antimicrobial susceptibility test with microdilution broth test method, the beta-lactamase gene, aminoglycosides modifying enzyme gene, disinfectans and sulfonamides-resistant gene carried on multidrug resistant Pseudomonas aeruginosa were de tected by polymerase chain reaction method, and the resistant gene sequences were identified. Results The positive rate of β -lactamase genes TEM, CARB, VIM expression was 24. 32 % （9/37）, 43.24% （16/37） and 5.41% （2/37） respectively,while the expression of SHV, CTX-M, OXA-lOgroup, PER, GES, VEB, DHA and IMP were not detectable. The absent rate of oprD2 was 86. 49% （32/37）. The positive rate of aminoglycosides modifying enzyme genes aac（6＇）-Ⅰ, aac （6＇）- Ⅱ , ant （3＂） Ⅰand ant （ 2＂）- Ⅰ expression was 8. 11% （3/37）, 43.24% （16/37）, 18.92 % （7/37） and 40. 54 % （15/37） respectively. The positive rate of disinfectants and sulfonamides-resistant gene qacE△1-sull expression was 51.35%（19/37）. Conclusion Pseudomonas aeruginosa involved in nosocomial infection carrys multidrug resistant genes, which severely affects clinical anti-infection therapy.

关 键 词：医院感染 铜绿假单胞菌 多重耐药 基因 抗药性 微生物 

分 类 号：R378.991[医药卫生—病原生物学]