深圳某地区铜绿假单胞菌分布和耐药情况及金属酶的携带分型研究  

The analysis of the distribution,drug resistance and the carried type of metalloenzyme of Pseudomonas aeruginosa in some place of Shenzhen

作　　者：徐羽中[1] 周淑懿 黄巧娱[1] 向开富[1] 卢霞芬 宋少琼 XU Yuzhong;ZHOU Shuyi;XIANG Kaifu;LU Xiafen;SONG Shaoqiong(Department of Clinical Laboratory,Baoan People′s Hospital,Shenzhen,Guangdong 518101,China;Clinical Laboratory Science of Southern Medical University,Guangzhou,Guangdong 510515,China)

机构地区：[1]南方医科大学附属深圳宝安人民医院检验科,广东深圳518101 [2]南方医科大学检验系,广东广州510515

出　　处：《国际检验医学杂志》2020年第S01期15-18,共4页International Journal of Laboratory Medicine

基　　金：宝安区科技创新基金项目(2016CX195)。

摘　　要：目的了解深圳地区三甲医院5年间铜绿假单胞菌(PA)的分布情况和耐药性,及多重耐药PA的金属酶(MBL)基因携带情况。方法收集南方医科大学附属深圳宝安人民医院2014-2018年住院患者细菌培养标本中分离的PA,鉴定及药敏使用西门子WalkAway40细菌鉴定仪和KB药敏纸片法;同时使用聚合酶链(PCR)实验检测耐药相关基因VIM、IMP、NDM、SIM、SPM,了解本地区耐药基因携带情况。结果5年共分离PA 1264株,其中多重耐药PA 322株;多重耐药PA 2014-2018年分离数量分别为61株(24.1%)、65株(31.4%)、84株(24.1%)、66株(29.9%)和46株(19.7%);多重耐药PA主要来源为重症医学科196株(15.5%)和神经外科176株(13.9%);标本以呼吸道(56.2%)和分泌物(15.8%)为主;氨曲南、替卡西林/克拉维酸和左氟氧沙星几种药物的耐药率较高,分别为19.4%、18.1%和15.3%。而耐药率较低的抗菌药物为阿米卡星、庆大霉素和妥布霉素,分别为2.2%、4.2%和4.4%。在112株多重耐药PA菌中MBL阳性38株,VIM阳性9株,IMP阳性1株,SPM阳性2株。结论PA多重耐药率几年来较高,提示临床用药应根据药敏结果合理用药,减少耐药菌株的诱导生成。Objective To study the distribution and drug resistance of Pseudomonas Aeruginosa(PA)and its carried type of metallo-β-lactamase(MBL).Therefore the results are supposed to provide significant information for therapeutic choices of antibiotics.Methods PA isolated from bacterial culture samples of inpatients in Bao′an people′s Hospital of Shenzhen affiliated to Southern Medical University from 2014 to 2018 was collected.Siemens walkaway 40 bacterial identification instrument and KB drug sensitive paper method were used for identification and drug sensitivity.At the same time,Polymerase Chain Reaction(PCR)was used to detect the drug-resistant related factors including VIM,imp,NDM,SIM and SPM to study the drug-resistant gene carrying situation in this area.Results One thousand two hundred and sixty-four Pseudomonas Aeruginosa strains were isolated and 322 multiple drug resistant strains were produced.The MDR rates for the past 5 years respectively were 24.1%、31.4%、24.1%、29.9%and 19.7%.When considering ward source,ICU 196cases(15.5%)had the highest isolating rate for Pseudomonas Aeruginosa strains,and the second one is neurosurgery 176 cases(13.9%).As for specimen source,56.2%were isolated from respiratory specimen and 15.8%were from secretion.The top three resistant antibiotics for all 1264 Pseudomonas Aeruginosa strains were Aztreonam(19.4%),Ticarcillin/Clavulanate(18.1%)and Levofloxacin(15.3%).At the same time Amikacin(2.2%),Gentamicin(4.2%)and Tobramycin(4.4%)had rather low resistant rates.Thirty eight strains of MBL were positive in 112 strains of MDRPA,including 9 of VIM,1 for IMP and 2 for SPM.Conclusion The MDRPA was higher in recent years than before,it is suggested that the rational use of drugs should be based on the results of drug sensitivity to reduce the induction of drug-resistant strains.

关 键 词：铜绿假单胞菌 多重耐药 分布 

分 类 号：R44[医药卫生—诊断学]