医院内铜绿假单胞菌耐药基因分布特点的研究

目的分析山东省两所三级甲等医院铜绿假单胞菌药物敏感性以及耐药基因分布特点。方法采用ATB系统进行细菌分离鉴定及药物敏感试验;聚合酶链反应检测三类耐药基因分布情况。结果 A医院菌株对哌拉西林-他唑巴坦和亚胺培南耐药性较高,B医院菌株对阿米卡星和妥布霉素耐药性较高。两所医院铜绿假单胞菌aac(3)-Ⅱa、ac(6′)-Ⅰa、ac(6′)-Ⅱ和parC耐药基因检出率差异有显著性(χ2=7.57~10.27,P<0.05);oprD2耐药基因缺失率均较高,差异无显著性(P>0.05)。黏液型和非黏液型菌株耐药基因检出率差异无显著性(P>0.05)。结论不同医院铜绿假单胞菌临床分离菌株均表现出多重耐药,但其耐药基因分布以及耐药情况有所不同。

DISTRIBUTION FEATURES OF DRUG RESISTANCE GENE OF PSEUDOMONAS AERUGINOSA IN HOSPITALS

Objective To analyze the drug resistance of pseudomonas aeruginosa and distribution features of their drug resistance genes in two province-level hospitals in Shandong province.Methods Bacteria isolation,identification and drug sensitivity test were performed following regulations of ATB system.Polymerases chain reaction` was used to detect the distribution of drug resistance of aminoglycoside modifying gene,quinolone gene and β-lactam gene.Results Strains in hospital A showed a higher resistance to piperacillin-tazobactam and imipenem;that in hospital B were higher resistance to amikacin and tobramycin.The differences of detection rates of aac(3)-Ⅱ,aac(6′)-Ⅰ,aac(6′)-Ⅱand parC in Pseudomonas aeruginosa were significant(χ2=7.57-10.27,P<0.05) between the two hospitals,though deletion rates of oprD2 drug resistance genes were higher,no significant difference were noted between them(P>0.05).No difference of detection rates was observed between mucous strain and non-mucous in terms of drug resistance gene(P>0.05).Conclusion Isolated strains of pseudomonas aeruginosa from different hospitals are all manifested with multi-drug resistance,but the distribution of drug resistance genes and extent of drug resistance are different.