铜绿假单胞菌耐药基因的分子流行病学研究

Multiresistant Genes of Pseudomonas aeruginosa in Different Areas: An Epidemiological Study

目的了解不同地区临床分离铜绿假单胞菌耐药基因的流行现状。方法对临床分离的104株铜绿假单胞菌采用ATB细菌鉴定仪鉴定菌种和K—B法测定抗菌药物的敏感性，利用聚合酶链反应（PCR）检测耐药基因（16种）和多分子标志法聚类分析菌株的亲缘性。结果3个地区铜绿假单胞菌对亚胺培南的耐药率依次为51．3％、80．0％和100．0％，对第三代头孢菌素的耐药率为48．2％～100．0％，耐药基因oprD2缺失率为90％～100％；多重耐药基因标志的菌株显示存在克隆传播现象，但绍兴地区流行耐药株以oprD2的缺失为主，湖州地区则以TEM、oprD2缺失、aac（3）-Ⅱ、ant（3”）-Ⅰ、qacEΔ1为主。结论3个地区临床分离的铜绿假单胞菌呈多重耐药，并由克隆传播导致医院感染，但耐药的机制并不相同。

OBJECTIVE To investigate the distribution of multiresistant genes produced by Pseudomonas aeruginosa （PAE） isolated from different areas. METHODS Antimicrobial sensitivities of 104 strains of PAE to 13 kinds of antibiotics were determined by K-B method, of which 16 kinds of drug resistant genes were tested by polymerase chain reaction （PCR） and analyzed by clustering method of multi-molecular markers. RESULTS The resistant detective rates to imipenam in three areas were respectively 51. 3%, 80%, and 100% and that to the third generation cephalosporin were moving from 48.2% to 100%. The detective rate of oprD2 absent was 90-100%. There were similar phenomena of prevalence between some strains in these areas, oprD2 Absent was the main mechanism of prevailing strains in Shaoxing, however, clone strains in Huzhou were caused by TEM, oprD2 absent,aac（3）-Ⅱ, ant （3＂）-Ⅰ and qacEΔ1. CONCLUSIONS There is a multiresistance to antibiotics in P AE isolated from different areas and the phenomena of prevalence are occurred in these areas, but the mechanisms of drug resistant are different.