烟台地区产金属β-内酰胺酶铜绿假单胞菌的耐药性分析及基因型检测  

Analysis of genotypes and antimicrobial resistance of metallo-beta-lactamase-producing Pseudomonas aeruginosa of Yantai area

作　　者：姜波[1] 吴金英[1] 伊茂礼[1] 杨少虹[1] 韩颖杰[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院检验科,264000

出　　处：《国际检验医学杂志》2009年第7期641-643,646,共4页International Journal of Laboratory Medicine

摘　　要：目的研究烟台地区产金属β-内酰胺酶铜绿假单胞菌的耐药性,基因型及菌株的同源性,为监控产酶菌株的流行及指导临床合理选择抗生素提供依据。方法EDTA纸片复合法和E-test法分别筛选产金属β-内酰胺酶菌株,PCR扩增耐药基因imp、vim、spm和gim,用MIC法测定产金属β-内酰胺酶菌株对8种常用抗菌药物的敏感度,用肠杆菌科基因间重复一致序列为引物的聚合酶链反应(ERIC PCR方法)确定菌株之间的同源性。结果42株耐亚胺培南和头胞他啶铜绿假单胞菌EDTA纸片复合法筛选出18株金属酶菌株、E-test法15株、PCR法12株;PCR法检测到imp阳性菌株4株,vim阳性菌株8株;产金属β-内酰胺酶菌株呈多重耐药,且PCR法阳性产金属酶菌株呈现为高水平耐药;ERIC-PCR结果显示,18株产金属β-内酰胺酶菌株呈现7种基因模型,其中10株为同一基因模型。结论经济简便快捷的EDTA纸片复合法可作为首选方法来对产金属酶铜绿假单胞菌进行筛选,烟台地区临床分离的铜绿假单胞菌所产金属β-内酰胺酶基因型以vim型为主,阿米卡星、环丙沙星具有较好的抗菌活性,某医院在一定时期曾出现爆发流行。Objective To study the genotypes, antimicrobial resistance and the homology of metallo-β-lactamase （MBL）-producing Pseudomonas aeruginosa isolated from clinical specimens in Yantai area, so as to provide basis for reasonable selection of antibiotics and monitoring of the preva- lence of metallo-beta-lactamase producing strains. Methods Metallo β-lactamase positive strains were screened from imipenem resistant and eeftazidime-resistant pseudomonas aeruginosa isolates by E-test strips method and EDTA-IMP disk diffusion method; PCR was performed to amplify the resistant genes of imp, vim, spm and gim. Microdilution test were used to determine the MICs of 8 antibiotics; the homology among different strains was tested by enterobaeterial repetitive intergenic consensus PCR （ERIC-PCR） method. Results Among 42 strains, there were 18 strains screened with EDTA-IMP disk diffusion method, 15 strains with E test, 12 strains with PCR, including 4 strains with specific bands of imp and 8 strains with vim bands. The metallo-β-lactamase-producing strains were multidrug resistant, and the PCR positive strains were highly resistant. Results of ERIC-PCR genotyping showed that there were seven PCR patterns among 18 strains screened by EDTA IMP disk diffusion method, and 10 strains were in the same pattern. Conclusion EDTA-IMP disk diffusion method may he the first choice to screen MBL producing strains in Pseudomonas aeruginosa because of its econo my, convenience and quickness. The major MBL genetype of Pseudomonas aeruginosa isolates is vim in Yantai area; the isolates are sensitive to amikacin and ciprofloxaein. The MBL producing strains in Pseudomonas aeruginosa appeared an outbreak in a certain hospital.

关 键 词：假单胞菌 铜绿 基因型 抗药性 细菌 Β-内酰胺酶类 山东 

分 类 号：R446.5[医药卫生—诊断学] R450[医药卫生—临床医学]