某三甲中医院耐碳青霉烯类铜绿假单胞菌临床分离株耐药性和同源性  

Drug resistance and homology of clinical carbapenem-resistant Pseudomonas aeruginosa isolates from a three-A traditional Chinese medicine hospital

作　　者：武文君[1] 王炜[2,7] 陈明心 李强[3,4] 荆鹏伟[1] 任伟宏 王海峰[5,6,7] 蒋雪松[2,7] WU Wen-jun;WANG Wei;CHEN Ming-xin;LI Qiang;JING Peng-wei;REN Wei-hong;WANG Hai-feng;JIANG Xue-song(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China;不详)

机构地区：[1]河南中医药大学第一附属医院检验科,河南郑州450000 [2]河南中医药大学第一附属医院感染控制科,河南郑州450000 [3]河南中医药大学第一附属医院艾滋病检测实验室,河南郑州450000 [4]河南省病毒性疾病中医药防治重点实验室,河南郑州45000 [5]河南中医药大学第一附属医院呼吸科,河南郑州450000 [6]呼吸疾病中医药防治省部共建协同创新中心,河南郑州45000 [7]河南省中医疫病工程研究中心,河南郑州450000

出　　处：《中华医院感染学杂志》2024年第22期3376-3381,共6页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金委员会面上基金资助项目(81774222);河南省高校科技创新团队支持计划经费基金资助项目(22IRTSTHN029)。

摘　　要：目的分析临床分离的耐碳青霉烯类铜绿假单胞菌(CRPA)耐药情况,通过基因测序对分离株进行同源性分析。方法收集河南中医药大学第一附属医院2021年7月-2022年6月临床首次分离的CRPA 35株,采用微量肉汤稀释法进行最低抑菌浓度(MIC)测定,使用聚合酶链扩增技术(PCR)扩增铜绿假单胞菌的7个管家基因并进行双脱氧序列测定(sanger测序),利用多位点序列分型方法对铜绿假单胞菌分离株进行分型,并使用基因序列,采用多位点序列分析方法构建分离株的系统进化树。结果35株CRPA主要分离于呼吸科、康复科、重症医学科(ICU),呼吸科分离的ST型别最多,高危型别在康复科分离最多。多位点序列分型显示35株CRPA可分为24个ST型,其中三种ST型是本次研究新发现型别。除多黏菌素、阿米卡星、庆大霉素外,对其他临床常用抗菌药物的耐药率均为40%以上,12种临床常用抗菌药物MIC在高危型别组和低危型别组间分布无统计学差异。结论高危型和非高危型CRPA的耐药率无差别,康复科高危型CRPA分离率高于临床其他科室。OBJECTIVE To investigate the drug resistance of clinical isolates of carbapenem-resistant Pseudomonas aeruginosa(CRPA)and analyze the homology of the isolates by gene sequencing.METHODS Totally 35 strains of carbapenem-resistant P.aeruginosa(CRPA)were clinically isolated from the First Affiliated Hospital of Henan University of Chinese Medicine from Jul.2021 to Jun.2022.The minimum inhibitory concentration(MIC)was determined with the use of broth microdilution method,7 housekeeping genes were amplified by using polymerase chain reaction(PCR),dideoxy sequencing(sanger sequencing)was performed,the genotypes of the P.aeruginosa strains were determined by multilocus sequence typing(MLST),and the phylogenetic tree was established based on the gene sequences by means of MLST.RESULTS The 35 strains of CRPA were mainly isolated from respiratory medicine department,rehabilitation department and critical care medicine department.Most of the ST types were isolated from the respiratory medicine department,and most of the high-risk types were isolated from the rehabilitation department.The MLST showed that the 35 strains of CRPA could be divided into 24 ST types,3 of which were novel types discovered in the research.Except for polymyxin,amikacin and gentamycin,the drug resistance rates to other commonly used antibiotics were more than 40%;there were no significant differences in the MICs of 12 types of commonly used antibiotics between the high-risk type group and the low-risk type group.CONCLUSION There is no difference in the drug resistance rate between the high-risk and non-high-risk CRPA strains,and the isolation rate of the high-risk CRPA strains is higher in the rehabilitation department than in other clinical departments.

关 键 词：耐碳青霉烯类铜绿假单胞菌 多位点序列分型 最低抑菌浓度 系统进化树 

分 类 号：R378.991[医药卫生—病原生物学]