耐亚胺培南铜绿假单胞菌β内酰胺类药物耐药相关基因的研究

Study on β-lactams Related Resistance Genes of Imipenem-Resistante Pseudomonas Aeruginosa

目的为了解临床分离的耐亚胺培南的铜绿假单胞菌（imipenem—resistante pseudomon asaeruginosa，IMPRPa）β内酰胺类药物耐药相关基因存在状况。方法将分离所得的18株全部耐亚胺培南的PA菌株进行产金属β内酰胺酶表型检测，聚合酶链反应（PCR）法对耐亚胺培南的铜绿假单胞菌进行β内酰胺类药物耐药相关基因在检测，并对部分耐药基因进行了DNA测序。结果10（55．6％）株产金属β内酰胺酶纸片协同法检测阳性，IMP、VIM、DHA、GES、CARB、TEM阳性率分别为22．2％（4／18）、33.3％（6／18）、11．1％（2／18）、33．3％（6／18）、16．7％（3／18）、22．2％（4／18），oprD2缺失率77．8％（14／18）。结论铜绿假单胞菌可存携带2种以上β内酰胺酶基因，能在同种和不同种细菌间横向传播，并产生多重耐药，严重影响临床的抗感染治疗。

Objective To study the β-1actams-related resistance genes of imipenem-resistante pseudomonas aeruginosa （IMPRPa） isolated in clinics. Methods Phenotypic detection of metallo-β-1actamase was performed in 18 stains IMPRPa. β-1actams-related resistance genes were detected with PCR in all IMPRPa and DNA sequencing were carried out in some of them. Results Metallo-β-1actamase detected by disc synergy test was positive in 10 strains （55.6%）. The positive rate of IMP, VIM, DHA, GES, CARB, TEM were 22.2% （4/18）, 33.3% （6/18）, 11.1% （2/18）, 33.3%（6/18）, 16.7% （3/18）, 22.2% （4/18） , respectively; deletion rate of oprD2 was 77.8% （14/18）. Conclusion There are two or more kinds of beta-lactamase genes in Pseudomonas aeruginosa, these genes can be communicated transversally in bacteria, produce multiply drug resistance and critically affect anti-infection treatment.