手术切口感染铜绿假单胞菌的MBLs基因检测和耐药性分析

目的研究住院患者手术切口感染铜绿假单胞菌的耐药性,并对碳青霉烯类耐药株进行分型和金属-内酰胺酶基因检测。方法分离自患者手术切口感染的铜绿假单胞菌186株,以铜绿假单胞菌ATCC27853,大肠埃希菌ATCC25922作为质控菌株,采用常见的8种抗生素进行药敏试验;利用ERIC-PCR对碳青霉烯类耐药株铜绿假单胞菌进行分型;利用IMP-PCR和VIM-PCR检测金属β-内酰胺酶基因。结果 186株铜绿假单胞菌对8种抗生素的耐药率分别为：庆大霉素和哌拉西林36.02%,阿米卡星和左氧氟沙星34.95%,美罗培南32.80%,环丙沙星32.26%,头孢吡肟27.42%,头孢他啶25.27%,其中62株耐碳青霉烯类铜绿假单细胞菌对美罗培南耐药率98.4%,且全部为多重耐药（MDR）,占总数的33.3%。11株为泛耐药株（PDR）,占总数的6%。4株VIM2型铜绿假单胞菌和1株IMP-25亚型金属β-内酰胺酶基因检测阳性。讨论随着近年来抗生素的频繁使用铜绿假单胞菌不断产生新的耐药株,并检出1株IMP-25亚型,这对研究铜绿假单胞菌的耐药性和流行病学特点具有重要意义。

Detection of MBL genes of Pseudomonas aeruginosainfecting surgical incisions and analysis of the drug resistance of P. aeruginosa

Objectives To study the drug resistance of Pseudomonas aeruginosainfecting surgical incisions,to type carbapenem-resistant strains,and to detect metallo-β-lactamase（MBL）genes and integrons with PCR. Methods In total,186 strains of P.aeruginosa were isolated from infected surgical incisions of patients at Kai Luan General Hospital,the Cancer Institute and Hospital of Tianjin Medical University,and He Bei General Hospital from 2010 to 2013.With P.aeruginosa ATCC27853 and Escherichia coli ATCC25922 serving as control strains,the drug resistance of P.aeruginosa was tested with 8antibiotics.ERI-PCR with primers was used to type 62 strains of carbapenem-resistant P.aeruginosa.MBL genes and integrons were detected with IMP-PCR and VIM-PCR. Results Results of drug susceptibility testing indicated the resistance of 186 strains of P.aeruginosato 8antibiotics.P.aeruginosaresistance to gentamicin and piperacillin was 36.02%,its resistance to amikacin and levofloxacin was 34.95%,its resistance to meropenem was 32.8%,its resistance to ciprofloxacin was 32.26%,its resistance to cefepime was 27.42%,and its resistance to ceftazidime was25.27%.Carbapenem-resistant P.aeruginosa was resistant to meropenem at a rate of 98.4%.The 62 strains of carbapenem-resistant P.aeruginosa were multi-drug-resistant at an overall rate of 33.3%.Eleven strains of carbapenem-resistant P.aeruginosa were pan-drug resistant at an overall rate of 6%.Results indicated that carbapenem-resistant P.aeruginosa had a higher rate of drug resistance than drug sensitivity.By year,there were 2strains of pan-drug-resistant P.aeruginosain 2010,2strains in 2011,3strains in 2012,and 4strains in 2013.MBL genes detected in the 186 strains were VIM2 in strains and IMP-25 in 1strain. Conclusion The frequent use of antibiotics over the past few years has led new strains of drug-resistant P.aeruginosa.The MBL gene IMP-25 was detected in 1strain.Studying the epidemiological characteristics and drug resistance of P.aeruginosais crucial to preventing an epidemic.