铜绿假单胞菌耐亚胺培南临床株的耐药基因的研究.docVIP

精品论文 参考文献 铜绿假单胞菌耐亚胺培南临床株的耐药基因的研究 于维林 朱元祺 任丽娟（青岛大学医学院附属医院 山东青岛 266003） 【中图分类号】R446【文献标识码】A【文章编号】1672-5085（2011）39-0081-02 【摘要】目的 分析耐亚胺培南铜绿假单胞菌临床株的耐药特征和耐药机制。方法 VITEK-compact微生物分析仪进行细菌鉴定和药物敏感试验； PCR法对铜绿假单胞菌亚胺培南耐药相关基因（IMP、VIM、GIM、OXA）和膜微孔蛋白基因oprD2进行检测。结果 66株耐亚胺培南铜绿假单胞菌对舒普深、特治星、阿米卡星的耐药率分别为38.5%、40.0%和44.6%，对头孢他啶、头孢吡肟和环丙沙星的耐药率分别为41.5%、43.1%和47.7%；66株耐亚胺培南铜绿假单胞菌中，IMP阳性11株（16.7%）、VIM 4株（6.0%），oprD2基因缺失5株（7.6%），其余耐药基因未检出。结论 铜绿假单胞菌多重耐药现象较为严重，其耐药机制主要与细菌产IMP型金属beta;-内酰胺酶以及膜微孔蛋白基因oprD2缺失有关。 【关键词】铜绿假单胞菌 亚胺培南 耐药基因 Study on antimicrobial resistance genes of imipenem-resistant Pseudomonas aeruginosa clinical isolates 【Abstract】 Objective To investigate the antimicrobial resistance characteristics and the mechanisms of imipenem-resistance of Pseudomonas aeruginosa producing carbapenemase. Methods Sixty five strains from patients were identified and drug susceptibility test was performed by VITEK-compact automatic microbial analysis system.The susceptibility of cefoperazone/sulbactam was performed by K-B method.The resistant genes of Pseudomonas aeruginosa isolates,including IMP ,VIM,GIM,SPM,GES,OXA and oprD2,were detected by PCR. Results The resistance rate of imipenem-resistance Pseudomonas aeruginosa isolates to cefoperazone sulbactam (Sulperazone) , piperacillinl tazobactam (Tazocin),amikacin, ceftazidime,cefepime(Maxipime) and ciprofloxacin was 38.5% ,40.0% , 44.6% ,41.5%,43.1% and 47.7%,respectively.Out of sixty five strains,11were positive for IMP gene（16.7%）,4 for VIM（6.0%）,5 for oprD2 （7.6%）Conclusion The P. aeruginosa isolates with imipenem-resistance shows seriou multidrug-resistance. It was the major antimicrobial merchanisms that the metallo-beta-lactamase producing of IMP and loss of oprD2 gene led to PA resistant to cephalosporins and carbapenems. 【Key words】 Pseudomonas aeruginosa Imipenem Carbapenemase Drug resistance genes 铜绿假单胞菌(Pseudomonas aeruginosa, PA)是一种常见的医院内获得性感染的重要条件致病菌。特别是耐亚胺培南铜绿假单胞菌（IMPRPA）的出现，给临床抗感染治疗带来很大困难。因此，我们分析了IMPRPA对常用抗菌药物的