呼吸重症监护病房多重耐药铜绿假单胞菌耐药基因研究  

Drug-resistant genes analysis of multi-drug resistant Pseudomonas aeruginosa in RICU

作　　者：阎锡新[1] 赵媛媛[2] 祁春艳[3] 潘文森[1] 张鲁涛[1] 

机构地区：[1]河北医科大学第二医院呼吸内科河北省呼吸疾病研究所,石家庄050000 [2]衡水市哈励逊国际和平医院重症医学科,053000 [3]石家庄市人民医院呼吸二科,050011

出　　处：《国际呼吸杂志》2010年第23期1431-1434,共4页International Journal of Respiration

摘　　要：目的观察我院呼吸重症监护病房（RICU）临床分离多重耐药铜绿假单胞菌B内酰胺酶基因和Ⅰ类整合子标志物（qacE△1-sull）存在状况。采用多基因聚类分析方法进行多重耐药菌株亲缘性分析。方法收集RICU分离多重耐药铜绿假单胞菌33株，采用PCR方法检测8种口内酰胺酶基因（TEM、SHV、PER、DHA、IMP、VIM、OXA-23、OXA24）和qacE△1-sull基因共9种。应用多基因聚类分析法分析菌株亲缘性。结果33株多重耐药铜绿假单胞菌中blaTEM阳性8株（24．24％），blaVIM阳性6株（18．19％），blaIMP阳性3株（9．09％），biaSHV阳性2株（6．06％），blaDHA阳性5株（15．15％），blaOXA23，blaOXA-24，blaPER均未检出，qacE△1-sull基因阳性28株（84．85％）。多基因聚类分析发现存在克隆传播现象。结论我院RICU多重耐药铜绿假单胞菌携带多种B一内酰胺酶基因，以携带blaTEM基因为主。qacE△1-sull携带率高，聚类分析显示存在克隆传播现象，应引起临床重视。Objective To investigate the positive rate of beta lactamase and qac△1 sull genes by polymerase chain reaction （PCR） method among clinical isolated strains of multi drug resistant Pseudornonas aeruginosa. The strains＇consanguinity were investigated by multi-genes cluster analysis. Methods Thirty-three strains of multi drug resistant Pseudomonas aeruginosa were isolated from hospitalized patients in RICU. β-Lactamase genes including TEM, SHV, PER, DHA, IMP, VIM, OXA-23, OXA-24 and qacE△1-sull, were detected by PCR amplication. The strains＇ homology were investigated by multi genes cluster analysis. Results PCR results showed the positive rates of genes blaTEM, blalMP, blaVIM, blaSHV, blaDHA, and qacE△1 sull in multi-drug resistant Pseudomonas aeruginosa were 24.24 %, 18.19 %, 9.09 %, 6.06 %, 15. 15% and 84.85 % respectively, while genes blaOXA 23, blaOXA- 24 and blaPER were all negative. Polygene cluster analysis results discovered that there is a clone transmitted phenomenon. Conclusions Multi-drug resistant Pseudomonas aeruginosa isolated in RICU have carried various beta lactamases genes and Multi drug resistant Pseudomonas aeruginosa mainly carried blaTEM. We must pay attention to the spread of clones occurred in our RICU and high positive percentages of qacE△1-sull in multi-drug resistant Pseudomonas aeruginosa.

关 键 词：多重耐药 铜绿假单胞菌 耐药基因 聚类分析 

分 类 号：R446.5[医药卫生—诊断学]