医院感染监测中铜绿假单胞菌氨基糖甙类抗生素耐药基因分析  

Analysis of aminoglycoside-resistance genes in Pseudomonas aeruginosa isolated in nosocomial infection surveillance

作　　者：宋启发[1] 林辉[1] 徐景野[1] 郑剑[1] 杨元斌[1] 

机构地区：[1]浙江省宁波市疾病预防控制中心微生物检验科,浙江宁波315010

出　　处：《中国卫生检验杂志》2010年第6期1433-1435,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:研究医院环境铜绿假单胞菌氨基糖甙类抗生素耐药基因携带情况及细菌耐药谱,为临床抗感染治疗和耐药监测提供理论依据。方法:从医院环境物体表面和患者中分离78株铜绿假单胞菌,采用K-B纸片法检测细菌对卡那霉素、庆大霉素、妥布霉素和阿米卡星4种氨基糖甙类抗生素耐药谱,采用PCR检测技术对相关耐药基因进行检测,并分析耐药基因与铜绿假单胞菌耐药表型间关系。结果:在检测的4种氨基糖甙类抗生素中,78株铜绿假单胞菌耐4种、3种、2种和1种抗生素的分别有39株(50%)、10株(12.8%)、5株(6.4%)和2株(2.6%),全敏感的有22株(28.2%)。PCR方法检出一种氨基糖甙类耐药基因的有41株(52.6%):aadB(n=15)、aacA4(n=8)、aadA1(n=20)、aadA6(n=6)、aacC1(n=2)和aadA2(n=2),有7株(9.0%)检出2到3种耐药基因,共有4种组合。结论:医院环境铜绿假单胞菌氨基糖甙类抗生素耐药基因携带率较高,与细菌多重耐药有密切关系,应引起临床重视。Objective：To investigate the diversity of resistance genes and antiobiotic resistance patterns against aminoglycosides in Pseudomonas aeruginosa isolated in nocoso surveillance to provide theoretical basis for antimicrobial treatment and antibiotic-resistance surveillance clinically.Methods：K-B method was performed to test bacterial resistance patterns against kanamycin,gentamicin,tobramycin and amikacin in 78 strains of Pseudomonas aeruginosa isolated from material surfaces and patients.Aminoglycoside-resistance genes were detected with PCR.The relationship between antimicrobial resistance patterns and resistance genes was analyzed.Results：Among 78 isolates,39（50%）,10（12.8%）,5（6.4%） and 2（2.6%） were resistant to 4,3,2 and 1 aminoglycosides,respectively,and 22（28.2%） were sensitive to all of 4 aminoglycosides.Using PCR,at least one of the following aminoglycoside-resistance genes was detected in 41（52.6 %） strains： aadB（n=15）,aacA4（n=8）,aadA1（n=20）,aadA6（n=6）,aacC1（n=2） and aadA2（n=2）,and 4 different combinations of 2 to 3 different resistance genes were observed in 7 strains（9.0 %）.Conclusion：High incidence of aminoglycoside-resistance genes was found in Pseudomonas aeruginosa isolated in hospital environment.Attention should be paid for the relationship between the resistance genes and multiple resistance phenotypes.

关 键 词：医院感染 铜绿假单胞菌 氨基糖甙类抗生素 多重抗药性 

分 类 号：R446.5[医药卫生—诊断学]