铜绿假单胞菌耐药性及耐药基因的对比研究  

Comparative study of drug resistance and drug resistance genes in clinical isolation of Pseudomonas aeruginosa

作　　者：陈璐[1] 查筑红[1] 冷应蓉[1] 程永素[1] 黄冰[1] 罗光英[1] 王敏[1] 

机构地区：[1]贵阳医学院附属医院感染管理科,贵州贵阳550004

出　　处：《中华医院感染学杂志》2014年第19期4702-4704,4719,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科技厅基金资助项目(黔科合J字[2011]-2153)

摘　　要：目的研究铜绿假单胞菌药敏特点,探讨铜绿假单胞菌耐药基因与耐药性关系。方法收集2012年6-12月医院各临床科室送检的标本,采用K-B法对40株铜绿假单胞菌进行抗菌药物敏感试验,根据药敏差异将其分成普通组23株(仅对β-内酰胺类抗菌药物耐药)和泛耐药组17株,对40株细菌利用PCR法扩增耐药相关基因,采用SPSS19.0统计软件进行分析。结果铜绿假单胞菌普通组23株占57.5%,泛耐药组17株占42.5%,普通组对阿米卡星、头孢吡肟、庆大霉素、亚胺培南、妥布霉素的耐药率,分别为0、8.7%、0、8.7%、4.3%,泛耐药组耐药率分别为94.1%、52.9%、100.0%、100.0%、100.0%,两组耐药率比较差异有统计学意义(P<0.05);普通组VIM、aac(6′)-Ⅰb、aac(6′)-Ⅱ、ant(2′)-Ⅰ基因检出率分别为0、100.0%、100.0%、52.2%,泛耐药组基因检出率分别为47.1%、70.6%、70.6%、100.0%,两组基因检出率比较差异有统计学意义(P<0.05)。结论产VIM型金属β-内酰胺酶是医院铜绿假单胞菌耐亚胺培南的主要机制之一,OprD2表达缺失与铜绿假单胞菌耐亚胺培南的关系有待进一步研究;产氨基糖苷类修饰酶不是细菌耐氨基糖苷类抗菌药物的决定性因素;医院分离的铜绿假单胞菌对季铵类、双胍类消毒剂耐药。OBJECTIVE To discuss the relationship of drug resistance and drug resistance genes of Pseudomonas aeruginosa on basis of research on its drug sensitivity characteristic.METHODS The method of K-B was used to test sensitivity of antibiotics to P.aeruginosa.The 40 strains of bacteria which were collected from testing specimens from Jun.2012 to Dec.2012,were divided into common group（23strains,and onlyβ-lactam antimicrobial resistance）and pan-drug resistant group（17strains）according to the drug sensitivity difference.The resistance genes of 40 strains of bacteria were determined by polymerase chain reaction（PCR）.SPSS19.0software was used for analysis.RESULTS There were 23 strains of common group（57.5%）and 17 strains of pandrug resistant group（42.5%）.The resistance rate difference of two groups of P.aeruginosa to amikacin（0/94.1%）,cefepime（8.7%/52.9%）,gentamicin（0/100.0%）,imipenem（8.7%/100.0%）and tobramycin（4.3%/100.0%）was significant（P〈0.05）.The positive rates of gene included VIM（0/47.1%）aac（6′）-Ⅰb（100.0%/70.6%）ant（2′）-Ⅰ（52.2%/100.0%）in two groups.The difference of the positive rates of two groups was significant.CONCLUSIONS The emerge of metallo-β-lactamase VIM in P.aeruginosa was one of the main mechanisms in our hospital.The relationship of lack of OprD2 expression and resistance to imipenem needed to be further studied.The emerging of aminoglycoside modifying enzymes was not the decisive factor for bacteria resistance to aminoglycoside antibiotics.Most of P.aeruginosaseparated from our hospital was high resistance to quaternary amine and biguanides disinfectant.

关 键 词：铜绿假单胞菌 耐药性 耐药基因 

分 类 号：R378.991[医药卫生—病原生物学]