台州地区铜绿假单胞菌产金属β-内酰胺酶的检测及-第三军医大学学报.DOCVIP

PAGE PAGE 4 台州地区铜绿假单胞菌产金属β-内酰胺酶的检测及耐药性分析 李俏俏 (台州市立医院呼吸科,浙江台州 318000) 通讯作者：李俏俏，E-mail 摘要: 目的 调查台州地区耐碳青霉烯类铜绿假单胞菌产金属β-内酰胺酶(MβL)的情况及其对临床常用抗菌药物的耐药性，为临床抗感染治疗提供依据。方法 采用K-B法进行药物敏感性试验，并筛选出耐碳青霉烯类的铜绿假单胞菌株；采用E-test法检测耐碳青霉烯类铜绿假单胞菌是否产MβL；采用PCR及DNA测序技术检测IMP、VIM、SIM-1、GIM-1和SPM-1这5种主要的MβL基因型。结果 在分离的180株铜绿假单胞菌中耐碳青霉烯类的有51株(28.3%)，其中产MβL的有13株(25.5%)；13株产酶菌株中IMP-1型MβL阳性8株，VIM-2型MβL阳性5株，未检测出SIM、GIM-1和SPM-1型MβL，且产MβL的铜绿假单胞菌对多种抗生素耐药且耐药率显著高于非产酶菌株（P0.05）。结论 本地区耐碳青霉烯类的铜绿假单胞菌检出率较高，多药耐药现象较严重，产MβL是铜绿假单胞菌对碳青霉烯类药物耐药的主要原因之一，且台州地区耐碳青霉烯类的铜绿假单胞菌以产IMP-1型和VIM-2型MβL为主，临床医师应加强对产酶株的临床检测和监控，合理选用抗菌药物。 关键词: 铜绿假单胞菌; 碳青霉烯类; 金属β-内酰胺酶; 耐药性 Detection and drug resistance analysis of Pseudomonas aeruginosa producing metallo-β-lactamase in Taizhou area? （LiQiaoqiao，Taizhou Municipal Hospital，Zhejiang，318000） Abstract: OBJECTIVE To investigate carbapenem resistant Pseudomonas aeruginosa producing metallo-β-lactamase(MβL) in Taizhou area?and drug resistance to clinical antibacterial agents, to provide evidences for clinical anti infection treatment. METHODS K-B was used for antimicrobial susceptibility testing, and screened strains of carbapenem resistant Pseudomonas aeruginosa. E-test was used to detect metallo-β-lactamase produced by carbapenem resistant Pseudomonas aeruginosa. PCR and DNA sequencing technology were used for detecting five main metallo-β-lactamase genotypes, including IMP, VIM, SIM-1, GIM-1 and SPM-1. RESULTS Carbapenems resistant Pseudomonas aeruginosa were 51 among 180 isolates, accounting for 28.3%, among which 13 isolates were producing metallo-β-lactamase, accounting for 25.5%. There were 8 isolates IMP-1 type MβL positive and 5 isolates VIM-2 type MβL positive among enzyme producing isolates, but SIM, GIM-1?and SPM-1 type MβL were not detected. Pseudomonas aeruginosa producing metallo-β-lactamase was resistant to many antibiotics and the resistant rate was significantly higher than that?of do not produce enzyme isolates (P0.05). CONCLUSION The detection rate of carbapenem resista