人工诱导亚胺培南耐药的医院铜绿假单胞菌耐药机制研究  

Drug-resistant mechanism of Pseudomonas aeruginosa induced by impenem in vitro in hospitalized patients

作　　者：钱超[1] 陈恬[1] 陆树娟 余建华[1] 穆琪[1] 常琪[1] 封欣[1] 冯卫忠[1] QIAN Chao CHEN Tian LU Shu-juan YU Jian.hua MU Qi CHANG Qi FENG Xin FENG Wei-zhong(454 Hospital of PLA ,Nanjing, Jiangsu 210002, China)

机构地区：[1]解放军第四五四医院检验科,江苏南京210002

出　　处：《中华医院感染学杂志》2017年第7期1441-1444,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨经亚胺培南(IMP)诱导产生耐药的铜绿假单胞菌(PA)的耐药表型及其耐药机制,旨在为临床有效治疗PA感染提供理论依据。方法收集2014年8月-2016年8月从临床送检标本中分离的抗菌药物全敏的PA株共计64株,以最终抗菌药物全敏的PA 62株临床分离株为实验菌株,分析比较各耐药相关表型在其中的作用,采用WHONET软件对数据进行统计分析。结果经人工诱导25代后获得的菌株都具有IMP耐药性;产MBL的IMP耐药PA(IRPA)47株,占75.8%;产ESBLs的IRPA 21株,占33.8%;产AmpC的IRPA 9株,占14.5%;主动外排系统表型阳性IRPA 3株,占4.8%。结论 PA产生IMP耐药性涉及MBL、ESBL、AmpC和主动外排系统激活等多种耐药机制,本组诱导耐药表型以MBL阳性为主。OBJECTIVE To investigate the drug-- resistant phenotype and mechanism of Pseudomonas aeruginosa （PA） induced by imipenem in vitro, so as to provide theoretical foundation for effective treatment of PA infection in clinic. METHODS A total of 64 PA strains with full antibacterial drugs sensitivity isolated in hospitalized pa- tients from Aug. 2014 to Aug. 2016 were collected. Totally 62 PA strains with full antibacterial drugs sensitivity were set as experimental strains, and the effects of different drug-resistant phenotypes were analyzed. The statisti- cal analysis of data was performed with the use of WHONET software. RESULTS All the PA strains induced by imipenem acquired imipenem resistance after 25 generations, and the drug-resistant phenotypes detection manifes- ted.. positive rates of MBL, ESBLs,AmpC,and active efflux pump were 75.8% （47 strains） ,33.8% （21 strains）, 14.5% （9 strains） and 4.8% （3 strains）, respectively. CONCLUSION Imipenem resistance of PA were involved with many drug-resistant mechanisms, including the activation of MBL, ESBLs, AmpC,and active efflux pump, and the major drug-resistant phenotype in this study was MBL-resistant.

关 键 词：铜绿假单胞菌 亚胺培南 耐药机制 金属Β-内酰胺酶 

分 类 号：R378.991[医药卫生—病原生物学]