耐亚胺培南铜绿假单胞菌的耐药特征及耐消毒剂基因的检测分析

Investigation on the antimicrobial resistance characteristics and disinfectant-resistant gene in imipenem-resistant Pseudomonas aeruginosa

目的 分析和调查我院2005年1月～12月临床分离34株耐亚胺培南铜绿假单胞菌对常用抗生素耐药特点以及耐消毒剂相关基因携带状况。方法 应用BD Phoenix100全自动微生物分析仪进行细菌鉴定和17种药物敏感试验，头孢哌酮／舒巴坦采用KB法。用PCR方法检测季胺类（如苯扎溴铵）、双胍类（如氯己定）耐药相关基因qac EΔ1-sull。结果 亚胺培南耐药铜绿假单胞菌除对阿米卡星100％敏感外，对哌拉西林、哌拉西林／三唑巴坦敏感率为48％～54％，对第三代及第四代头孢菌素、氨曲南和喹诺酮类等抗菌活性差，敏感率为3％～29％，对美罗培南敏感率为29％，对氨苄西林／舒巴坦、氯霉素、四环素、复方磺胺甲噁唑全部耐药。34株亚胺培南耐药铜绿假单胞菌有14株EΔl-sull基因阳性，携带率为41．2％。结论 本组亚胺培南耐药铜绿假单胞菌除对阿米卡星敏感外，对其它常用抗生素耐药严重，且耐消毒剂相关基因阳性携带率较高，应引起临床微生物和消毒界的重视。

Objective To investigate the antimicrobial resistance characteristics and the condition of disinfectant-resistant gene （qacEΔ1-sull） in 34 imipenem-resistant Pseudomonas aeruginosa. Method Thirty-four strains from patients from Jan to Dee 2005 were identified and drug susceptibility test were performed by BD Phoenix100 automatic microbial analysis system, cefoperazone/sulbactam susceptibility test was performed by Kirby-Bauer method. The qacEΔ1-sull gene was detected by PCR method. Results Imipenem-resistant Pseudomonas aeruginosa were all susceptible to amikacin, 48-54% were susceptible to piperacillin and pipereillin/tazobactam,respeetively. Only 3-29% were susceptible to the other cephlosporins, aztreonam and quinolones. There were 29% of Pseudomonas aeruginosa susceptible to meropenem and all resistance to amoxicillin/clavulanate, chloramphenicol, tetracycline and trimethoprim/sulfamethoxazole. Fourteen of 34 strains were qacEΔ1-sull-gene positive, and the carrying rate was 41.2%. Conclusion The resistance status of Pseudomonas aeruginosa to imipenem is serious. There is high positive percentage of qacEΔ1-sull gene in imipenem-resistant Pseudomonas aeruginosa.