亚胺培南耐药铜绿假单胞菌金属β内酰胺酶的检测和同源性分析  

Production of metallo-β-lactamases and homology in imipenem-resistant Pseudomonas aeruginosa

作　　者：简翠[1] 孙自镛[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院检验科,武汉430030

出　　处：《中国感染与化疗杂志》2008年第2期107-111,共5页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解亚胺培南耐药铜绿假单胞菌的耐药性、同源性及金属β内酰胺酶类型。方法收集我院2006年1—9月临床分离的亚胺培南耐药铜绿假单胞菌29株,用琼脂稀释法测定10种抗菌药物的MIC;通过改良Hodge试验、双纸片协同试验、PCR、序列分析等方法分析金属β内酰胺酶类型,紫外分光光度法测定金属β内酰胺酶的活性;脉冲场凝胶电泳(PFGE)分析菌株同源性。结果29株细菌均为多重耐药株,仅对哌拉西林-他唑巴坦和阿米卡星敏感率较高,分别为69.7%和60.6%。29株细菌PFGE图谱分为16个基因型,A型主要集中在呼吸内科病房,B、C型来自神经外科ICU,D、E型来自器官移植病房,F型来自创伤外科病房,G型来自神经内科病房,其余为散在分布。29株菌中有2株产VIM-2金属β内酰胺酶(6.9%)。结论本院亚胺培南耐药铜绿假单胞菌主要为医院感染流行株,且呈多重耐药,有2株菌产VIM-2型金属β内酰胺酶。Objective To investigate the resistance and homology of imipenem-resistant Pseudomonas aeruginosa and typing of metallo-β-lactamases. Methods Agar dilution technique was used to determine the minimal inhibitory concentrations （MIC） of antibiotics against 29 strains of imipenem-resistant P. aeruginosa collected from Tongji Hospital between January and September in 2006. These strains were analyzed by pulsed-field gel electrophoresis （PFGE）. The metallo-β-lactamases produced by these strains were typed by the modified Hodge test, double-disk synergy test, polymerase chain reaction, and sequencing analysis. The metallo-β-lactamase activity was determined spectrophotometrically. Results The 29 strains were all muhi-drug resistant. The strains susceptible to piperacillin-tazobactam and amikacin accounted for 69. 7% and 60. 6% respectively. The 29 strains were classified into 16 types based on PFGE pattern. Type A was isolated from pulmonology ward. Type B and type C were isolated from neurosurgery ICU. Type D and type E were isolated from Department of Transplant Surgery. Type F was from to ward of wound surgery. Two strains produced VIM-2 metallo-β-lactamases. Conclusions The prevalent strains of imipenem-resistant P. aeruginosa are isolated from nosoeomial infection in our hospital, which are multi-resistant. Metallo-β-laetamase is identified in two isolates.

关 键 词：铜绿假单胞菌 耐药性 多重耐药 脉冲场凝胶电泳 

分 类 号：R446.5[医药卫生—诊断学]