携带bla_(VIM-2)耐药基因的恶臭假单胞菌致皮肤感染一例并文献复习  

Skin infection caused by Pseudomonas putida harboring drug resistance gene of bla_(VIM-2):a case report and literature review

作　　者：李永慧 张志强[2] 孔庆山[1] 赵飞[1] LI Yonghui;ZHANG Zhiqiang;KONG Qingshan;ZHAO Fei(The Second Hospital of Qinhuangdao,Qinhuangdao 066004,China;Hebei Normal University of Scienceand Technology,Hebei Province Key Laboratory of Veterinary Preventive Medicine,Qinhuangdao 066004,China)

机构地区：[1]秦皇岛市第二医院,河北秦皇岛066004 [2]河北科技师范学院,河北秦皇岛066004

出　　处：《中国麻风皮肤病杂志》2024年第11期765-768,共4页China Journal of Leprosy and Skin Diseases

基　　金：国家重点研发计划子课题(编号:2023YFD1800701-01);秦皇岛市科技计划项目(编号:202301A094)。

摘　　要：恶臭假单胞菌能够引起多种鱼类的败血性感染,但对人的致病性一直被忽视。本研究从一例63岁男性患者左下肢皮肤伤口中分离到一株优势细菌,经生化鉴定和16S RNA测序分析确认为恶臭假单胞菌。进一步对其进行药敏试验,发现该菌株对氨苄西林、多种头孢类抗生素、碳青霉烯类抗生素、复方新诺明耐药,耐药基因检测发现该分离株携带抗碳青霉烯类bla_(VIM-2)耐药基因。根据药敏试验结果选用头孢他啶注射液2 g,每日两次,疗程14天,外用夫西地酸乳膏,每日2次,2个月后患者皮损完全愈合。Pseudomonas putida can cause a variety of fish septic infection,but which effect on humans has not been paid much attention.Pseudomonas putida was separated from the wound on the left lower limb of a 63-year-old male,which confirmed by the biochemical identification and 16s RNA sequencing.The results of drug sensitivity test showed that the isolate was resistant to ampicillin,multiple cephalosporin antibiotics,carbapenem antibiotics,and cotrimoxazole.Further examination of resistance genes revealed that the isolate carried the carbapenem-resistance gene bla_(VIM-2).According to the results of drug sensitivity test,the patient was treated with ceftazidime injection 2 g,twice a day for 14 days,and fusidic acid cream was applied additionally,twice a day,and the lesion healed completely after 2 months.

关 键 词：恶臭假单胞菌 组织病理 细菌分离鉴定 药敏实验 耐药基因 

分 类 号：R446.5[医药卫生—诊断学] R751[医药卫生—临床医学]