铜绿假单胞菌的耐药现状及外膜通道蛋白OprD_2的研究

目的了解铜绿假单胞菌临床分布情况、耐药现状以及外膜通道蛋白OprD2的缺失与亚胺培南耐药的相关性。方法收集2011-2013年深圳市第二人民医院临床分离到的949株铜绿假单胞菌,采用K-B纸片扩散法进行12种抗生素药敏试验,通过设计引物,运用聚合酶链反应(PCR)方法扩增oprD2基因。结果共949株铜绿假单胞菌,分离率前两位的科室是神经外科和ICU病房,分别占25.40%和22.76%;铜绿假单胞菌对12种抗生素的药敏试验中,最敏感的是阿米卡星(85.88%),其次是氨曲南(85.25%),耐药率最高的是头孢他啶(37.09%),对亚胺培南耐药的有312株,即亚胺培南耐药铜绿假单胞菌(IRPA)的分离率为32.88%(312/949);2012年6-12月筛选的81株IRPA中,有42株oprD2基因缺失,缺失率为51.85%。结论临床分离铜绿假单胞菌耐药性严重,外膜通道蛋白OprD2缺失可能是铜绿假单胞菌对亚胺培南耐药的主要原因之一。

Study on antibiotics resistance and outer membrane channel protein OprD2 of Pseudomonas aeruginosa

Objective To investigate distribution and drug resistance of Pseudomonas aeruginosa （PA）, and analyse the relationship between deletion of outer membrane channel protein OprD2 in PA and its imipenem resistance. Methods The anti-microbial susceptibility test was performed by K-B slip diffusion method in all 949 Pseudomonas aeruginosa isolates from 2011 to 2013. Polymerase chain reaction （PCR） was used to amplify oprD2 gene. Results In the 949 Pseudomonas aeruginosa strains, the detection rates of PA in neurosurgery and ICU were the top two highest, accounted for 25.40% and 22.76%, respectively. Of the antibiotics sensitive rate to Amikaein was the highest （85.88%）, the second was Aztreonam （85.25%） and the highest resistant rate was Ceftazidime （37.09%）.312 of 949 strains were detected resistant lmipenem,the resistant rate of IRPA was 32.88% and 42 strains were lack of oprD2 gene, with a loss rate of 51.85%. Conclusions The drug resistance phenomenon of PA is serious. The loss of OprD2 may contribute to the resistance of PA to Imipenem.