耐亚胺培南铜绿假单胞菌的耐药机制研究  

Investigation on mechanism of imipenem-resistant Pseudomonas aeruginosa

作　　者：孙震[1] 殷俊[1] 高伟[1] 叶英[1] 程君[1] 李家斌[1,2] 

机构地区：[1]安徽医科大学第一附属医院,合肥230022 [2]安徽省细菌耐药性监控中心,合肥230022

出　　处：《中国抗生素杂志》2009年第1期52-56,共5页Chinese Journal of Antibiotics

基　　金：国家自然科学基金项目(No.30571654)。

摘　　要：目的对临床分离的14株耐亚胺培南铜绿假单胞菌的耐药机制进行研究。方法药敏试验检测对15种常用抗菌药物的耐药情况;协同试验筛选产金属酶菌株和聚合酶链反应检测金属酶基因及oprD基因;氰氯苯腙检测主动外排情况及其对亚胺培南最低抑菌浓度(MIC)的影响。结果耐亚胺培南的铜绿假单胞菌对其它常用抗菌药物耐药率也很高,其中,5株产VIM-2型金属酶,11株oprD基因检测阴性。2株在有氰氯苯腙存在时对亚胺培南的MIC降低至原值的1/4,表明这2株有主动外排系统参与对亚胺培南的耐药。结论OprD2蛋白表达缺失是本研究中铜绿假单胞菌对亚胺培南耐药的主要原因,其次为产VIM-2型金属酶和主动外排系统,且至少有4株存在两种以上耐亚胺培南的机制。Objective To study the resistance mechanism of 14 imipenem-resistant Pseudomonas aeruginosa isolated from clinical patients. Methods Antimicrobial susceptibility test was performed to detect the minimal inhibitory concentration （MIC） of 15 antimicrobial agents. Using disc synergy test to screen metallo-beta-lactamase, PCR method was employed to examine the genes of metallo-beta-lactamases and outer membrane protein, namely OprD2; Carbonyl cyanide 3-chlorophenylhydrazone（CCCP） was used to study the effect on the MICs of imipenem and active efflux pumps system. Results The imipenem-resistant Pseudomonas aeruginosa were highly resistant to other 14 antimi- crobial agents. Of metallo-beta-lactamase-producing 5 strains were positive for VIM-2 gene. oprD gene was negative in 11 strains;2 strains had active efflux pumps system since their MICs to imipenem were cut down to 1/4 affected by CCCP. Conclusions The loss of outer membrane protein OprD2 was the main reason to imipenem-resistant Pseu- domonas aeruginosa, the minor reasons were metallo-beta-lactamase-producing and active efflux pumps system. In addition, two or more kinds of resistant mechanisms might exist in at least 4 of 14 imipenem-resistant Pseudomonas aerugtnosa.

关 键 词：铜绿假单胞菌 金属酶 OprD2蛋白 主动外排系统 

分 类 号：R378.99[医药卫生—病原生物学]