耐亚胺培南铜绿假单胞菌的耐药机制研究  

Resistance mechanism of imipenem-resistant Pseudomonas aeruginosa

作　　者：闫玉兰[1] 郭世辉[1] 李萌[1] 吴晓宁[1] 梁宏洁[1] 

机构地区：[1]广西医科大学第一附属医院检验科,广西南宁530021

出　　处：《中华医院感染学杂志》2014年第15期3650-3652,共3页Chinese Journal of Nosocomiology

基　　金：广西自然科学基金资助项目(桂科自2010GXNSFA013172);广西卫生厅科研基金资助项目(桂卫Z2010371)

摘　　要：目的分析医院耐亚胺培南铜绿假单胞菌(IRPA)的耐药机制以指导临床用药,为临床资料提供参考依据。方法将2011年6月-2012年12医院临床分离的IRPA 106株,采用琼脂稀释法检测其MIC,用纸片法进行金属酶表型筛选;用PCR方法检测IRPA的金属酶基因、外排基因oprM以及外膜通道蛋白基因。结果 106株IRPA中检出20株产金属β-内酰胺酶(MBL),均为VIM-2基因;检出9株携带主动外排基因oprM;检出外膜通道蛋白基因oprD2缺失99株,缺失率为93.4%。结论医院铜绿假单胞菌对亚胺培南的耐药机制主要为外膜通道蛋白基因oprD2的缺失、金属酶的产生以及主动外排机制的表达。OBJECTIVE To analyze the resigtance mechanism of imipenem-resistant Pseudomonas aeruginosa （IR- PA） in our hospital to guide clinical treatment. METHODS The minimum inhibitory concentration （MIC） for 106 strains of IRPA clinically isolated in our hospital in Jun. 2011 to Dec. 2012 was detected by agar dilution method. Metalloenzyme phenotypic screening was conducted with paper method. The β-1actamase gene, efflux gene oprM and the outer membrane channel protein gene were determined by PCR method. RESULTS Totally among the 106 strains of IRPA, 20 strains were metalproducing β-lactamase, carrying VIM-2 genge; 9 IRPA carried oprM gene; 99 strains （93.4%） were detected to lack of oprD2 gene. CONCLUSION The primary resistance mechanism of IR- PA to imipenem was deficiency of oprD2 gene, production of MBL, and expression of efflux pump.

关 键 词：铜绿假单胞菌 亚胺培南 耐药机制 

分 类 号：R378.991[医药卫生—病原生物学]