基于耐药基因OPRD2探讨铜绿假单胞菌的临床感染特性  

A Study on Clinical Infection Characteristics of P. Aeruginosa Based on the Drug Resistance Gene OPRD2

作　　者：丁军颖[1,2] 桂红[3] 洪燕英[3] 安世栋[1,2] 丁雪菲 卢幼然 刘清泉[1,2] 

机构地区：[1]首都医科大学附属北京中医医院 [2]北京市中医研究所中医感染性疾病基础研究北京市重点实验室,北京100010 [3]首都医科大学附属北京中医医院检验科,北京100010

出　　处：《解放军医药杂志》2015年第10期69-71,75,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家自然科学基金项目(81373813);国家"重大新药创制"科技重大专项(2013ZX09102026)

摘　　要：目的探讨2014年首都医科大学附属北京中医医院铜绿假单胞菌临床感染的分布情况,并分析其耐药特点。方法分离2014年全院感染病例的送检标本15 620例,留存铜绿假单胞菌,以最小抑菌浓度(MIC)法检测其对20种抗生素的敏感性,并对全耐药的铜绿假单胞菌进行耐药基因外膜蛋白D2(OPRD2)的检测。结果本研究分离非重复病原菌5075株,铜绿假单胞菌332株(6.54%)。标本来源以痰液为主,主要发生在疮疡外科、呼吸科和重症监护病房。分离的铜绿假单胞菌对阿米卡星最敏感;对头孢唑啉耐药率最高。对20种抗生素均耐药9株铜绿假单胞菌其OPRD2耐药基因并非全部缺失。结论临床感染铜绿假单胞菌比例大,范围广。加强对铜绿假单胞菌感染及耐药性的监测,尤其相关耐药基因的检测,可为临床合理治疗提供依据。Objective To investigate the clinical infection distribution of Pseudomonas Aeruginosa（ P. Aeruginosa） in Beijing Hospital of TCM in 2014,and to analyze the characteristics of its drug resistance. Methods A total of15 620 samples of infection cases in 2014 were isolated,and the P. Aeruginosa was reserved. The drug sensitivities against 20 antibiotics were detected using minimal inhibitory concentration（ MIC） method,and the detection for drug resistance gene outer membrane protein D2（ OPRD2） was performed in whole drug resistant P. Aeruginosa strains. Results A total of 5075 pathogens were isolated in this study,including the 332 P. Aeruginosa strains（ 6. 54%）. The samples mostly came from phlegm,and the infection mostly occurred in the sores ulceration,respiratory diseases and ICU departments. The isolated P. Aeruginosa had the most sensitivity against Amikacin,and the highest drug resistance rate against Cephazolin. The 9 P. Aeruginosa strains were total drug resistant against 20 antibiotics,and their OPRD2 drug resistance genes were not all lost. Conclusion The rate of P. Aeruginosa infection is high with wide range in clinical practice. To strengthen the monitoring of the P. Aeruginosa infection and drug resistance,especially to strengthen the surveillance of related genes of drug resistance may provide the basis for the reasonable treatment.

关 键 词：耐药基因 临床感染 铜绿假单胞菌 细菌外膜蛋白 

分 类 号：R378.991[医药卫生—病原生物学]