耐碳青霉烯类铜绿假单胞菌整合子检测与耐药性分析  

Detection of integrons in carbapenem-resistant Pseudomonas aeruginosa and analysis of drug resistance

作　　者：李情操[1] 卢雯君[1] 吴巧萍[1] 魏取好[2] 

机构地区：[1]宁波市医疗中心李惠利医院检验科,浙江宁波315040 [2]浙江省人民医院检验科,浙江杭州310014

出　　处：《中华医院感染学杂志》2016年第10期2172-2175,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81101291);浙江省自然科学基金资助项目(Y2110743)

摘　　要：目的了解医院耐碳青霉烯类铜绿假单胞菌中整合子的分布及可变区中基因盒的类型与细菌耐药性的关系,为控制医院感染提供依据。方法采用聚合酶链反应(PCR)扩增和琼脂糖凝胶电泳的方法对宁波市医疗中心李惠利医院2012-2014年临床分离的336株耐碳青霉烯铜绿假单胞菌第1、2类整合子进行筛查,并对整合子阳性菌株的可变区序列进行测序分析;采用WHONET5.6和SPSS18.0软件对数据进行统计分析。结果 336株临床菌株中第1类整合子阳性菌株共有42株,阳性率为12.5%;没有筛选到第2类整合子阳性菌株;42株整合子阳性菌株中,23株可变区基因盒为aadA6△-orfd,10株可变区基因盒为aadA6△-ISPa21-aadA6△-orfd,为氨基糖苷类抗菌药物的耐药基因,其余9株可变区未整合基因盒;整合基因盒aadA6△-orfd菌株组阿米卡星、庆大霉素、妥布霉素的耐药率均明显高于未整合基因盒菌株组(P<0.05);而整合基因盒aadA6△-ISPa21-aadA6△-orfd菌株组阿米卡星、庆大霉素、妥布霉素的耐药率介于上述两组之间;42株整合子阳性菌株对阿米卡星、哌拉西林/他唑巴坦、庆大霉素、头孢吡肟、头孢他啶、妥布霉素和左氧氟沙星的耐药率分别为57.1%、73.8%、85.7%、80.9%、95.2%、83.3%和88.1%,均显著高于整合子阴性菌株(P<0.01)。结论耐碳青霉烯类铜绿假单胞菌整合子的携带率相对较低,可变区所携带的耐药基因主要为氨基糖苷类抗菌药物的耐药基因,基因盒与菌株的耐药性呈高度相关,整合子可能还存在着其他机制参与耐药表型的产生。OBJECTIVE To understand the distribution of integrons of carbapenem-resistant Pseudomonas aeruginosa and analyze the relationship between the type of gene cassettes in variable regions and the drug resistance so as to provide guidance for control of nosocomial infections.METHODS The class 1and class 2integrons of 336 clinical carbapenem-resistant P.aeruginosastrains that were isolated from Ningbo Medical Center Li Hui-li Hospital from2012 to 2014were screened by means of polymerase chain reaction（PCR）amplification and agarose gel electrophoresis,the sequences in the variable regions of the integrons-positive strains were sequenced,and the statistical analysis of data was performed with the use of WHONET5.6and SPSS18.0software.RESULTS Of the 336 clinical isolates,42 isolates were positive for the class 1integron,with the positive rate of 12.5%,while no isolate was positive for the class 2integron.Of the 42integron-positive isolates,23 isolates had the gene cassette of variable region aadA6△-orfd,10 isolates had the gene cassette of variable region aadA6△-ISPa21-aadA6△-orfd,which was the drug resistance gene to aminoglycosides,and the remaining 9isolates were not integrated gene cassettes of variable region.The drug resistance rate of the strains with aadA6△-orfdto amikacin,gentamicin,or tobramycin was significantly higher than that of the strains without integrated gene cassette（P〈0.05）.However,the drug resistance rate of the strains with aadA6△-ISPa21-aadA6△-orfdto amikacin,gentamicin,or tobramycin varied between the two above groups.The drug resistance rates of the 42integron-positive isolates to amikacin,piperacillin-tazobactam,gentamicin,cefepime,ceftazidime,tobramycin,and levofloxacin were 57.1%,73.8%,85.7%,80.9%,95.2%,83.3%,and 88.1%,respectively,significantly higher than those of the integron-negative strains（P〈0.01）.CONCLUSIONThe carrying rate of integron is low in the carbapenem-resistant P.aeruginosa,and the aminoglycoside antibiotic resistance genes are dominant among the dru

关 键 词：铜绿假单胞菌 整合子 可变区 耐药性 

分 类 号：R378[医药卫生—病原生物学]