多药耐药铜绿假单胞菌耐药性及相关耐药基因分析

目的探讨临床分离的多重耐药铜绿假单胞菌耐药性及相关耐药基因。方法采用纸片扩散法进行药敏试验,VITEK 2全自动微生物鉴定及药敏系统对其进行重新鉴定,聚合酶链反应（PCR）扩增oprD2、金属酶基因、氨基糖苷类酶修饰基因。结果 40株铜绿假单胞菌对临床常用的抗生素：厄它培南,亚胺培南（IPM）、头孢他啶（CAZ）、美罗培南、头孢吡肟（PEP）、哌拉西林/他唑巴坦（TZP）、环丙沙星、氨曲南（ATM）、庆大霉素（GEN）、妥布霉素、阿米卡星、多粘菌素耐药率分别为100%、96.2%、92.0%、90.1%、84.8%、83.9%、83.1%、73.7%、65.1%、60.6%、58.0%、0%。PCR结果显示oprD2缺失率65.0%,整合子阳性率22.5%,发现金属酶基因IMP-1株,氨基糖苷类修饰酶基因ant3Ⅰ、aac6Ⅱ、aac6Ⅰ、ant2Ⅰ基因阳性率分别为36.0%、35.1%、26.2%,20.1%,同时携带2种或2种以上耐药基因占55.0%,携带2种以上氨基糖苷类修饰基因的有40.0%。结论多重耐药铜绿假单胞菌耐药性高,携带多种氨基糖苷类修饰酶基因,外膜孔蛋白oprD2缺失在多药耐药铜绿假单胞很常见,另外携带多种耐药基因盒的整合子的存在也是细菌耐药的常见原因,应引起高度重视。

Reasearch on the part of resistant genes and risistance to antibiotics of multi-drug resistant Pseudomonas aeruginosa

Objective To investigate the antibiotic resistance and the resistant genes of multi-drug resistant Pseudomonas aeruginosa.Methods The antimicrobial susceptibility was evaluated by disk diffusion test.The oprD2 gene and aminoglycoside-modifying enzyme gene carried multi-drug resistant Pseudomonas aeruginosa were detected by polymerase chain reaction（PCR）.Results In 40 strains of multi-drug resistant Pseudomonas aeruginosa,the drug resistant rates,as to some antibiotics commonly used in the clinic,such as Ertapenem,Imipenem,Ceftazidime,meropenem,Cefepine,Piperacillin/Tazobactam,ciprofloxacin,Aztreonam,Gentamicin,Todramycin,Amikacin and polymycin B,were 100%,96.2%,92.0%,90.1%,84.8%,83.9%,83.1%,73.7%,65.1%,60.6%,58.0%,0% respectively.The posistive rates of ant3,aac6,aac6Ⅰand ant2Ⅰ among aminoglycoside-modifying enzyme genes in 40 multi-drug resistant Pseudomonas aeruginosa were 36.0%,35.1%,26.2% and 20.1% respectively.The loss rate of oprD2 gene was 65.0%.The posistive rates of class Ⅰintegron gene were 22.5%.Only one strains were foud IMP-1.Conclusion It was high resistantance to antibiotics of multi-drug resistant Pseudomonas aeruginosa which caryying a variety of aminoglycoside-modifying enzyme genes and class Ⅰintegron gene.The absence of gene oprD2 were common.These findings suggest that it shoud be paid much more attention to multi-drug resistant Pseudomonas aeruginosa.