铜绿假单胞菌耐碳青霉烯类相关基因研究的荟萃分析  

Meta analysis of carbapenems-resistance genes in Pseudomonas aeruginosa

作　　者：明德松[1,2] 邓勇[2] 

机构地区：[1]泉州医学高等专科学校医学检验教研室,福建泉州362000 [2]福建医科大学附属泉州第一医院感染科,福建泉州362000

出　　处：《中华医院感染学杂志》2013年第16期3821-3823,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解我国临床分离的耐碳青霉烯类铜绿假单胞菌(CRPA)的相关耐药基因分布,为铜绿假单胞菌的耐药研究和临床治疗提供依据。方法采用荟萃分析方法,分析我国16个省市铜绿假单胞菌耐碳青霉烯类基因型的分布。结果 16个省市中1140株CRPA外膜通道蛋白oprD2基因缺陷在华中和东北地区检出率最高,分别为87.0%和100.0%;编码金属酶基因VIM在东北和西南地区检出率最高,分别为20.0%和11.5%;IMP在东北地区检出率最高,为40.0%,其他基因型在各个地方呈散在分布;oprD2基因缺陷、编码金属酶基因IMP、编码金属酶基因VIM、编码丝氨酸酶基因OXA、主动外排系统基因MEX等5种基因检出率分别为55.0%、15.4%、9.4%、3.2%、11.4%,oprD2基因缺陷检出率最高,明显高于其他基因检出率,差异有统计学意义(P<0.01)。结论我国CRPA耐碳青霉烯类相关基因变化以oprD2基因缺陷为主,其次是编码金属酶基因IMP、VIM及编码丝氨酸酶基因OXA的异常表达,主动外排系统基因也是一个重要因素。OBJECTIVE To investigate the distribution of the related drug resistance genes in carbapenems-resistant Pseudomonas aeruginosa（CRPA）so as to provide basis for the study of drug resistance of P.aeruginosaand the clinical treatment.METHODS By means of the meta analysis,the genotypes of carbapenems-resistance genes in P.aeruginosaisolated from fifteen provinces and cities were analyzed.RESULTS Of totally 1140strains of CRPA isolated from 16provinces and cities,the detection rate of OprD2was the highest in the central China（87.0%）or in the northeastern China（100.0%）,and the detection rate of metalloenzyme-producing gene VIM was the highest in the northeastern China（20.0%）or in the southwestern China（11.5%）;the detection rate of IMPwas the highest in the northeastern China（40.0%）;and other genotypes scattered in various places.The detection rates of the oprD2defect,IMP,VIM,OXA,and MEX were 55.0%,15.4%,9.4%,3.2%,and 11.4%,respectively,and the detection rate of the oprD2defect was significantly higher than that of other genes,the difference was significant（P0.01）.CONCLUSION The oprD2gene defect is dominant in CRPA,followed by the abnormal expression of metalloenzyme-producing gene VIM,blaIMPand blaVIM.Efflux pump gene is also an important factor.

关 键 词：铜绿假单胞菌 碳青霉烯类 oprD2基因 金属酶 丝氨酸酶 外排泵 

分 类 号：R378.991[医药卫生—病原生物学]