ICU呼吸道铜绿假单胞菌耐药性及其耐药基因分型研究

目的 探讨重症监护室(intensive care unit,ICU)中铜绿假单胞菌(Pseudomonas aeruginosa,PA)感染的耐药情况和耐药基因分型特点,为临床治疗提供参考依据.方法 收集邢台医学高等专科学校第二附属医院ICU病房送检的临床标本中分离的PA,药物敏感性试验检测PA对抗菌药物的敏感性,聚...

Study on the drug resistance of Pseudomonas aeruginosa from the respiratory tract in the ICU and its drug resistance genotyping

ObjectiveTo investigate the drug resistance of Pseudomonas aeruginosa(PA) infection and characteristics of drug resistance genotyping in intensive care unit(ICU), and to provide reference for clinical treatment.MethodsThe PA isolated from clinical specimens submitted for examination in the ICU ward of the Second Affiliated Hospital of Xingtai Medical College was collected. The sensitivity test was used to detect the sensitivity of PA to antibacterial drugs, and the drug-resistant genotype was detected by polymerase chain reaction(PCR).ResultsA total of 42 strains of PA strains from lower respiratory tract were screened for this study. The resistance rate of PA to amikacin, tobramycin, imipenem and polymyxin B was less than 30%. The resistance rate to gentamicin, levofloxacin, piperacillin, tazobactam, cefepime and ceftazidime was between 30.0% and 40.0%, the resistance rate to ciprofloxacin, meropenem and aztreonam was more than 40.0%, and to polymyxin B was 0.0%, and the sensitivity rate was 100%. The blaCTX-M-1 gene carrying rate of the extended-spectrum β-lactamase-related resistance gene was 7.1%(3/42), the blaIMP gene carrying rate of the carbapenem-related resistance genes was 19.0%(8/42) ), and blaOXA-1 gene carrying rate was 16.7%(7/42). Carrying rate of Aminoglycoside-related drug resistance gene carrying aac(6′)-Ⅰb gene was 23.8%(10/42), and that carrying ant(2″)-Ⅰa was 19.0%(8/42). The efflux pump gene OprD2 deletion rate was 19.0%(8/42), and the classⅠintegron carrying rate was 23.8%(10/42).ConclusionPA infections in ICU wards are mainly found in the respiratory tract. Except for amikacin, tobramycin, imipenem and polymyxin B, the resistance rate to other drugs is relatively high, and antibacterial drugs should be used rationally based on drug sensitivity tests. PA-related drug resistance genes are mainly aac(6′)-Ⅰb and class Ⅰ integrons, which are conducive to the study of resistance reversal mechanisms.