80株铜绿假单胞菌对亚胺培南耐药机制的研究  

Mechanisms of imipenem resistance in 80 Pseudomonas aeruginosa strains

作　　者：哈瑞 李刚[2] 师志云[2] 武涛 赵志军 贾伟[2] HA Rui;LI Gang;SHI Zhiyun;WU Tao;ZHAO Zhijun;JIA Wei(Ningxia Medical University,Yinchuan,Ningxia 750004,China;Department of Medical Laboratories,General Hospital of Ningxia Medical University,Yinchuan,Ningxia 750004,China;Department of Prevention and Health Protection,General Hospital of Ningxia Medical University,Yinchuan,Ningxia 750004,China;Ningxia Key Laboratory of Pathogenic Microorganisms,Yinchuan,Ningxia 750004,China)

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学总医院医学检验中心,宁夏银川750004 [3]宁夏医科大学总医院预防保健科,宁夏银川750004 [4]宁夏病原微生物重点实验室,宁夏银川750004

出　　处：《国际检验医学杂志》2019年第21期2617-2620,共4页International Journal of Laboratory Medicine

基　　金：宁夏自然科学基金资助项目(NZ17149、NZ17169、2019AAC03216);宁夏高等学校一流学科建设基金资金资助项目(NXYLXK2017A05)

摘　　要：目的检测和研究耐亚胺培南铜绿假单胞菌的临床特征及耐药机制。方法对2016年1月至2017年9月该院临床分离的80株耐亚胺培南铜绿假单胞菌的科室分布、标本类型及耐药性进行回顾性分析;运用PCR检测耐亚胺培南铜绿假单胞菌耐药基因bla IMP、bla VIM、bla NDM-1、bla SIM、bla SPM、bla GIM、bla OXA-10及膜孔蛋白OprD 2基因。结果该院以神经外科送检标本的耐亚胺培南铜绿假单胞菌检出(28.0%)最多,主要分离自呼吸道标本(86.0%)。80株耐亚胺培南铜绿假单胞菌对阿米卡星的耐药率最低(7.5%),对复方磺胺甲噁唑的耐药率最高(97.5%)。耐药基因检测结果显示:bla VIM基因阳性1株(1.2%),bla OXA-10基因阳性4株(5.0%),其他耐药基因均未检出;膜孔蛋白OprD 2基因缺失67株(83.8%)。结论本研究中铜绿假单胞菌对亚胺培南耐药的主要机制是膜孔蛋白OprD 2基因的缺失。Objective To detect and study the clinical characteristics and drug resistance mechanism of imipenem-resistant Pseudomonas aeruginosa.Methods A retrospective analysis was made on the distribution,specimen type and drug resistance of 80 strains of imipenem-resistant Pseudomonas aeruginosa from January 2016 to September 2017.The resistance genes bla IMP,bla VIM,bla NDM-1,bla SIM,bla SPM,bla GIM,bla OXA-10 and OprD 2 of imipenem-resistant Pseudomonas aeruginosa were detected by PCR.Results The highest detection number of imipenem-resistant Pseudomonas aeruginosa was found in neurosurgical specimens(28.0%),mainly isolated from respiratory tract specimens(86.0%).A total of 80 strains imipenem-resistant Pseudomonas aeruginosa had the lowest resistance rate to amikacin(7.5%)and the highest resistance rate to compound neotamine(97.5%).The results of drug resistance gene detection showed that 1 strain(1.2%)was bla VIM gene positive,4 strains(5.0%)were bla OXA-10 gene positive,and no other drug resistance genes were detected;67 strains(83.8%)were OprD 2 gene deleted.Conclusion The main mechanism of resistance of Pseudomonas aeruginosa to imipenem is the deletion of OprD 2 gene.

关 键 词：铜绿假单胞菌 亚胺培南 耐药基因 

分 类 号：R372[医药卫生—病原生物学]