多重耐药铜绿假单胞菌耐药基因及亲缘性分析  

Antimicrobial-resistant Genes and Consanguinity in Multi-resistant Pseudomonas aeruginosa

作　　者：黄支密[1] 单浩[1] 郭满盈[1] 陈榆[1] 仵蕾[1] 糜祖煌[2] 诸葛青云[3] 秦玲[2] 

机构地区：[1]解放军第98医院,浙江湖州313000 [2]无锡市克隆遗传技术研究所,江苏无锡214026 [3]温州医学院茶山校区寄生虫教研室,浙江温州325000

出　　处：《中华医院感染学杂志》2007年第4期366-369,共4页Chinese Journal of Nosocomiology

基　　金：CLON-GEN细菌耐药基因研究专项基金资助(20041001HZ)

摘　　要：目的了解解放军第98医院临床分离的多重耐药铜绿假单胞菌(MRPA)中抗菌药物相关耐药基因存在状况及菌株亲缘性。方法在2003年9月-2004年10月间从临床分离30株MRPA,采用PCR及序列分析的方法分析24种基因blaTEM、blaSHV、blaOXA-10群、blaPER、blaVEB、blaIMP、blaVIM、blaGES、blaCARB、blaDHA、blaMIR、aac(3)-Ⅰ、aac(3)-Ⅱ、aac(3)-Ⅲ、aac(3)-Ⅳ、aac(6′)-Ⅰ、aac(6′)-Ⅱ、ant(3″)-Ⅰ、ant(2″)-Ⅰ、aph(3′)-Ⅵ、oprD、qacE△1-sul1、catB、cml1,采用Average法进行耐药基因聚类分析以确定菌株亲缘性。结果30株MRPA中blaTEM、blaOXA-10群、blaCARB、aac(3)-Ⅱ、aac(6′)-Ⅰ、aac(6′)-Ⅱ、ant(3″)-Ⅰ、ant(2″)-Ⅰ、qacE△1-sul1和cml1基因的阳性率分别为66.7%、3.3%、3.3%、76.7%、3.3%、33.3%、53.3%、26.7%、83.3%和3.3%,blaOXA-10群基因经序列分析确认为blaOXA-10型ESBLs,27株(90.0%)发生oprD基因缺失突变;其他基因均阴性;根据耐药基因聚类分析该30株MRPA可分4群,为医院感染所致。结论临床分离的MRPA中至少存在10种耐药基因,oprD基因缺失突变率很高,MRPA可导致克隆传播医院感染,并存在暴发性流行。OBJECTIVE To investigate the antimicrobial-resistant genes and consanguinity in multi-resistant Pseudomonas aeruginosa （MRPA） isolated from the 98th Hospital of PLA, Huzhou, Zhejiang Province,China. METHODS Thirty strains of MRPA were isolated from hospitalized patients between Sep 2003 and Oct 2004. Twenty four kinds of genes of blaTEM ,blaSHV, blaoxA-10 group, blaPER、blaVEB、blaIMP、blaVIM、blaGES、blaCARB、blaDHA、blaMIR、aac（3）-Ⅰ、aac（3）-Ⅱ、aac（3）-Ⅲ、aac（3）-Ⅳ、aac（6＇）-Ⅰ、aac（6＇）-Ⅱ、ant（3＂）-Ⅰ、ant（2＂）-Ⅰ、aph（3＇）-Ⅵ、oprD、qacE△1-sul1, catB,and cmll were analyzed by PCR and verified by DNA sequencing. Resistant-genes cluster analysis was performed by Average. RESULTS In 30 strains of MRPA the positive rate of genes of blaTEM, blaoxA-10 group, blacARB , aac（3）-Ⅱ、aac（6＇）-Ⅰ、aac（6＇）-Ⅱ、ant（3＂）-Ⅰ、ant（2＂）-Ⅰ、qacE△1-sul1, and cml1 were 66.7 % 3.3%,3.3%,76.7%,3.3%,33.3%,53, 3%,26.7%,83.3%,and 3.3%, respectively,and the deficiency rate of oprD gene was 90.0%. The gene of blaoxA 10 group was sequenced and determined to be blaoxA-10 subtype ESBL gene. But the rest of genes were all negative. According to the cluster analysis of resistant-gene, 30 strains of MRPA isolated could be classified into four subgroups, which were caused by the infection in hospital. CONCLUSIONS At least 10 kinds of antimicrobial-resistant genes exist in MRPA isolates, and the deficiency rate of oprD gene is very high. MRPA can induce clone transmitted hospital infection and it has fulminant prevalence.

关 键 词：医院感染 铜绿假单胞菌 多重耐药 耐药基因 聚类分析 

分 类 号：R378.991[医药卫生—病原生物学]