34株耐亚胺培南铜绿假单胞菌的药物敏感分析及耐药机制探讨  

Drug Sensitivity Analysis and Drug Resistance Mechanism of 34 Imipenem Resistant Pseudomonas Aeruginosa Strains

作　　者：蒋逸 沈佳丽[1] 蒋文玥 史伟峰[2] JIANG Yi;SHEN Jia-li;JIANG Wen-yue;SHI Wei-feng(Department of Laboratory,Wujin people＇s Hospital,Changzhou,Jiangsu,213161;Department of Laboratory,First People＇s Hospital of Changzhou,Changzhou,Jiangsu,213003)

机构地区：[1]常州市武进人民医院检验科,江苏常州213161 [2]常州市第一人民医院检验科,江苏常州213003

出　　处：《智慧健康》2018年第19期19-20,共2页Smart Healthcare

摘　　要：目的分析耐亚胺培南铜绿假单胞菌(IRPA)的药物结果及耐药机制。方法收集我院IRPA 34株,分析药敏试验结果及外排泵基因表达水平和膜孔蛋白opr D2表达水平。结果分离的IRPA,来自痰标本的比例最高(70.6%),脑外科占的比重最大(58.8%),对阿米卡星的耐药率最低(2.9%);34株IRPA中膜孔蛋白opr D2基因缺失11株,缺失率为32.4%;Mex A超表达的PA有8株(23.5%),Mex X超表达的PA有9株(26.5%),Mex C超表达的PA有11株(32.4%),Mex E超表达的PA有10株(29.4%)。结论 IRPA耐药机制复杂,TEM-1超广谱β-内酰胺酶、膜孔蛋白opr D2缺失、主动外排泵超表达及携带的I类整合子移动元件可能是耐药的主要机制。Objective To analyze the drug resistance and mechanism of imipenem resistant Pseudomonas aeruginosa（IRPA）. Methods： 34 strains of IRPA in our hospital were collected, and the results of drug sensitivity test, gene expression level of efflux pump and expression level of membrane protein opr D2 were analyzed. Results： The proportion of isolated IRPA from sputum specimens was the highest（70.6%）, the proportion of Department of cerebral surgery was the largest（58.8%）, the resistance rate to Amikacin was the lowest（2.9%）; 34 strains of IRPA were missing 11 strains, and the loss rate was 32.4%; Mex A overexpressed PA had 8（23.5%）, and Mex X overexpressed PA had 9（26.5%）, M Ex C overexpressed PA in 11 strains（32.4%）, and Mex E overexpressed PA in 10（29.4%）. Conclusion： The resistance mechanism of IRPA is complex, and the TEM-1 hyper broad-spectrum beta lactamase, the deletion of the membrane pore protein opr D2, the overexpression of the active efflux pump and the carrier I integron mobile element may be the main mechanism of the drug resistance.

关 键 词：IRPA 耐药 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]