| 铜绿假单胞菌对碳青霉烯类抗生素耐药性 |
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| 引用本文： | 费静娴, 吴莲凤, 彭定辉, 屠鸿翔, 周明明, 李超, 包其郁, 周铁丽. 铜绿假单胞菌对碳青霉烯类抗生素耐药性[J]. 中国公共卫生, 2010, 26(10): 1258-1260. DOI: 10.11847/zgggws2010-26-10-21 |
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| 作者姓名： | 费静娴 吴莲凤 彭定辉 屠鸿翔 周明明 李超 包其郁 周铁丽 |
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| 作者单位： | 1.温州医学院附属第一医院实验诊断中心, 浙江 温州 325000;2.武汉大学中南医院检验科;3.温州医学院 |
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| 摘 要： | 目的 探讨铜绿假单胞菌对碳青霉烯类抗生素的耐药性和耐药机制。方法 选取温州医学院附属第一医院162株铜绿假单胞菌临床分离株,采用琼脂稀释法检测抗生素亚胺培南和美罗培南对铜绿假单胞菌的最低抑菌浓度(MIC);PCR扩增分离株外膜蛋白基因OprD2和碳青霉烯酶基因VIM、IMP、SPM、KPC,对阳性产物测序确定基因亚型;羰基氰氯苯腙(CCCP)协同抑制试验检测膜外排机制。结果 162株分离菌株中,亚胺培南和美罗培南的耐药率分别为37.0%和30.9%;60株耐亚胺培南和/或美罗培南菌株(简称耐药株)中,50株对2种抗生素均耐药,另10株仅对亚胺培南耐药;耐药株中有18株OprD2基因缺失,102株不耐亚胺培南或美罗培南菌株(简称敏感株)中有20株OprD2基因缺失;耐药株中检出13株碳青霉烯酶阳性,其中5株产VIM型,8株产IMP型,敏感株中未检出VIM、IMP基因,所有菌株中未检出SPM-1、KPC基因;耐药株有48.3%外排泵表型试验阳性,以亚胺培南和美罗培南作为底物的分别有19株和24株,敏感株有10.8%外排试验阳性。结论 铜绿假单胞菌对碳青霉烯类抗生素耐药严重,与外膜蛋白OprD2缺失、产碳青霉烯酶和主动外排共同作用有关。
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| 关 键 词： | 铜绿假单胞菌 耐药机制 碳青霉烯类 OprD2 碳青霉烯酶 外排泵 羰基氰氯苯腙 |
| 收稿时间： | 2010-01-19 |
Carbapenem resistance mechanisms of Pseudomonas aeruginosa |
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| FEI Jing-xian, WU Lian-feng, PENG Ding-hui, . Carbapenem resistance mechanisms of Pseudomonas aeruginosa[J]. Chinese Journal of Public Health, 2010, 26(10): 1258-1260. DOI: 10.11847/zgggws2010-26-10-21 |
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| Authors: | FEI Jing-xian WU Lian-feng PENG Ding-hui |
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| Affiliation: | 1.Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical College Wenzhou 325000, China |
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| Abstract: | Objective To investigate the characteristics and carbapenem-resistant mechanisms of Pseudomonas aerugi nosa(P.aeruginosa).Methods Minmium inhibitory concentration(MIC) of imipenem and meropenemagainst 162 strains of P.aeruginosa isolated from hospital were detected with agar dilution method.All the strains were screened for the outer membrane protein gene OprD2 and carbapenemase genes such as VIM,MIP,SPM,and KPC with PCR,and then conformed with direct sequencing to identify subtypes.Carbonyl cyanidem-chloropheny lhydrazone(CCCP) was used as efflux pump inhibitor to detect membrane efflux mechanism.Results Among 162 strains tested,imipenem and meropenem resistance rates were 37.0% and 30.9%,respectively.In 60 imipenem and/or meropenem-resistant strains,50 strains were resistant to both drugs and the other 10 strains were only resistant to imipenem.In the resistant group,18 strains had a OprD2 gene deletion,while in 102 into lerant strains of imipenem or meropenem(the sensitive strains),20 strains had a OprD2 gene deletion. Thirteen carbapenemase positive strains were detected in the resistant group,5 of which were producing VIM-type,and 8 producing IMP-type.VIM,MIP genes were not detected in the sensitive group,and nostra in was detected positive in SPM-1,KPC gene.4813% of the resistant strains were efflux phenotype test positive,19 and 24 of which took imipenem and meropenem as substrates.10.8% of the sensitive strains were positive in the efflux test.Conclusion The situation of carbapenem resistance of P.aeruginosa is serious.The carbapenem resistance of P.aeruginosa results from interaction of severalm echanisms such as outermembrane protein loss,carbapenemase producing and active efflux pumping. |
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| Keywords: | OprD2 |
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