汕头地区耐亚胺培南铜绿假单胞菌耐药分析

目的：了解汕头地区对亚胺培南耐药的铜绿假单胞菌（PA）的耐药情况及耐药机制。方法：收集临床分离耐亚胺培南的PA共141株，双纸片协同实验检测金属酶表型，PCR法检测外膜孔蛋白OprD2和金属β内酰胺酶（IMP、VIM、SPM）基因。结果：耐亚胺培南的铜绿假单胞菌均为多重耐药茵，对头孢哌酮／舒巴坦的耐药率较低，未发现产金属酶菌株，仅22株菌株扩增出OprD2基因。结论：头孢哌酮／舒巴坦可作为本地区临床治疗耐亚胺培南铜绿假单胞茵所致感染的首选经验用药，OprDa表达减少或不表达可能是临床分离铜绿假单胞茵对亚胺培南耐药的主要机制。

Analysis of resistance in imipenem-resistant Pseudomonas aeruginosa in Shantou area

Toinvestigate the prevalence and resistance mechnisms of imipenem-resistant Pseudomonas aeruginosa （PA） in Shantou area. Methods： 141 clinical isolates of PA resistant to imipenem were collected. Production of metallo β-lactamase（MBL） was determined by double-disk synergy test. PCR amplification for genes encoding MBL（IMP, VIM, SPM）and OprD2 were performed. Results： All of the imipenem-resistant PA isolates were multi-resistant. Cefoperazone/tazobactam showed better activity than other antibiotics. No isolate produced MBL. OprD2 was detected in twenty-two isolates. Conclusions： Cefoperazone/tazobactam can be used in the infection caused by imipenem-resistant PA. Loss or decreased expression of OprD2 was the major mechnism of imipenem resistance in PA.