亚胺培南耐药的铜绿假单胞菌中I类整合酶基因的研究  

Study on integrase I gene in imipenem-resistant Pseudomonas aeruginosa

作　　者：张桔红[1] 张娟[1] 蔡应木[1] 王佩芬[1] 黄源春[1] 

机构地区：[1]汕头大学医学院第一附属医院检验科,广东汕头515041

出　　处：《中国热带医学》2010年第5期538-539,596,共3页China Tropical Medicine

基　　金：2007年汕头市重点科技计划项目项目编号:2007-76

摘　　要：目的了解我院临床分离的耐亚胺培南(IMP)的铜绿假单胞菌(PA)中I类整合酶基因(intI1)和耐消毒剂-磺胺相关基因(qacE△1-sulI)的存在状况,追溯我院耐亚胺培南铜绿假单胞菌(IRPA)的来源及其耐药机理。方法采用VITEK-AMS60全自动微生物仪进行菌株鉴定和药敏试验,随机挑选自临床分离的60株铜绿假单胞菌(其中30株IMP耐药的PA,30株IMP敏感的PA)。采用聚合酶链反应(PCR)技术及序列分析法检测I类整合子遗传标记(intI1和qacE△1-sulI)基因。结果 IMP耐药组对抗生素的耐药率明显高于IMP敏感组;30株IMP耐药的PA中有23株(76.7%)intI1阳性,11株(36.7%)qacE△1-sulI阳性;另30株IMP敏感的PA中有12株(40.0%)intI1阳性,3株(10.0%)qacE△1-sulI阳性.阳性基因主要来自神经外科,其次是神经内科和外科ICU病房。结论 I类整合子遗传标记基因(intI1和qacE△1-sulI)与PA的耐药和多重耐药具有相关性,特别是IRPA中intI1基因携带率很高,提示intI1基因可能是PA耐IMP及多重耐药的一个重要原因.临床应合理使用抗生素,减少耐药菌株的产生,同时对重点科室的感染控制措施,加强对耐药基因在病原菌种属间传播和扩散的监测工作。Aim To investigate the source and drug-resistant mechamism of integrase Ⅰ gene （including intI1 and qacE △1-sulI） in imipenem-resistant Pseudomonas aeruginosa （IRPA） isolated from the clinical specimens in our hospita. Methods Bacteria were identified and susceptibihty test were conducted by VITEK-AMS 60 auto microbial system. The integron genetic markers were analyzed from 60 isolated strains of P.aeruginosa by polymerase chain reaction （PCR） and verificated by DNA sequencing. Results In 30 strains of IRPA, the positive rates of gene of intI1, qacE△1-sulI were 23 （76.7%）, 11 （36.7%）; in other 30 strains of imipenem-sensitivity, the positive rates of gene of intI1, qacE △1-sulI were 12 （40.0%）,3 （10.0%）. The positive genes were main from neurosurgery department, second were nerve medicine department and surgical ICU ward. Conclusion Integrase I gene （including intI1 and qacEAl-suU） is associated with multi-drug resistance of P.aeruginosa,especiaUy intIl genes were very high,the higher level of intI1 genes is possibly an relevant to drag resisstance and multi--drug resistance of P. aerug/nosa. In order to reduce the drug-resistance strains,antibiotics should be used reasonably in addition to strengthening the monitoring of drag-resistant genes of pathogens.

关 键 词：铜绿假单胞菌 亚胺培南 Ⅰ类整合子 多重耐药 

分 类 号：R378.991[医药卫生—病原生物学]