耐碳青霉烯类铜绿假单胞菌血流感染耐药基因及毒力因子分析  

Analysis of Drug Resistance Genes and Virulence Factors of Carbapenem-resistant Pseudomonas Aeruginosa Bloodstream Infection

作　　者：刘晶[1] 韩晶[1] 吴小莎 马玉芹 Liu Jing;Han Jing;Wu Xiaosha;Ma Yuqin(Department of Laboratory Medicine,Anyang People's Hospital,Anyang 455000,China)

机构地区：[1]安阳市人民医院检验科,河南安阳455000

出　　处：《哈尔滨医药》2023年第4期41-43,共3页Harbin Medical Journal

摘　　要：目的 分析耐碳青霉烯类铜绿假单胞菌(CR-PA)血流感染(BSI)耐药基因及毒力因子。方法 选取发生铜绿假单胞菌(PA)BSI的156例住院患者为研究对象,培养其血液、尿液、痰液等标本后获得51株CR-PA,分析CR-PA的抗菌药物药敏试验结果以及耐药基因、毒力基因阳性检出率。结果 51株CR-PA中耐药率≥50%的抗菌药物从高到低依次为头孢吡肟、美罗培南、阿米卡星、复方新诺明、庆大霉素、亚胺培南,而敏感率≥50%的抗菌药物从高到低依次为哌拉西林+三唑巴坦绿脓菌素、环丙沙星、替卡西林,其中哌拉西林+三唑巴坦绿脓菌素是耐药率最低且药敏感率最高的抗菌药物。在51株CR-PA中,ant(2’’)-Ⅰ耐药基因阳性率(58.82%)、plcH毒力基因阳性率(100.00%)最高,其次阳性率超过50.00%的耐药基因分别为aprA(98.04%)、exoS(92.16%)、algD(82.35%)、exoT(82.35%)、exoU(68.63%)。结论 BSI患者CR-PA中耐药基因、毒力基因分布广泛,其中以耐药基因ant(2’’)-Ⅰ与毒力基因plcH的临床分离率较高。Objective To analyze the drug resistance genes and virulence factors of carbapenem-resistant pseudomonas aeruginosa(CR-PA)bloodstream infection(BSI).Methods A total of 156 inpatients with pseudomonas aeruginosa(PA)BSI were selected as the research subjects,51 strains of CR-PA were obtained after culturing their blood,urine,sputum and other samples.The antibacterial drug susceptibility test results of CR-PA and the positive detection rate of drug resistance genes and virulence genes were analyzed.Results Among the 51 CR-PA strains,the antibacterial drugs with the resistance rate≥50%were cefepime,meropenem,amikacin,cotrimoxazole,gentamicin and imipenem from high to low.Antibacterial drugs with the resistance rate≥50%were piperacillin+tazobactampyocyanin,ciprofloxacin and ticarcillin from high to low.Among them,piperacillin+tazobactampyocyanin was the antibacterial drug with the lowest resistance rate and the highest drug sensitivity rate.Among the 51 strains of CR-PA,the positive rate of resistance gene ant(2'')-I(58.82%)and virulence gene plcH(100.00%)were the highest.And the drug resistance genes with a positive rate over 50.00%were aprA(98.04%),exoS(92.16%),algD(82.35%),exoT(82.35%),and exoU(68.63%).Conclusions The drug resistance genes and virulence genes are widely distributed in CR-PA of BSI patients,and the clinical isolation rate of drug resistance gene ant(2'')-Ⅰand virulence gene plcH is high.

关 键 词：血流感染 耐碳青霉烯类 铜绿假单胞菌 耐药基因 毒力因子 

分 类 号：R446.11[医药卫生—诊断学]