耐亚胺培南铜绿假单胞菌的耐药性及相关基因研究

A study of drug resistance and related genes of imipenem-resistant pseudomonas aeruginosa

目的:研究铜绿假单胞菌对亚胺培南的耐药机制。方法:取69株临床分离的耐亚胺培南铜绿假单胞菌(Imipenem-re-sistant pseudomon asaeruginosa,IRPA),经K-B法检测耐药性;用PCR法对铜绿假单胞菌亚胺培南耐药相关的金属酶IMP、VIM基因和外膜蛋白OprD2基因等3种主要耐药基因进行了检测与分析;结果:69株IRPA均为多重耐药菌,对阿米卡星、头孢哌酮/舒巴坦、头孢吡肟敏感性较高;检出金属酶IMP和VIM型金属酶基因阳性的分别有2株(2/69,2.9%)和4株(4/69,5.8%),外膜蛋白通道OprD2基因检测为缺失的有46株(46/69,66.7%)。结论:IRPA耐药情况严重。外膜蛋白通道OprD2基因缺失突变是本组铜绿假单胞菌对亚胺培南耐药的重要机制之一。

Objective ： To study the mechanisms of imipenem resistance in Pseudomonas aeruginosa. Methods： Drug resistance of 69 isolates of imipenem-resistant Pseudomonas aeruginosa （IRPA） were tested by Kirby-Bauer disk diffusion method ; IMP and VIM genes of metallo- β -lactamases, and outer membrane protein D2（ OprD2 ） gene of IRPA were detected and analyzed by PCR method. Results： All 69 isolates were multidrug resistant, and the sensitivity rates of AMK, CFS and FEP were highe. The positive rates for IMP gene and VIM gene were 2.9% （2/69） and 5.8% （4/69）, respectively. 46 of 69 （66.7%） isolates presented with deletion for OprD2 gene. Conclusion：The drug resistance of IRPA is a serious issue.The deletion mutation of OprD2 gene is one of important mechanisms of imipenem resistance in these tested P.aeruginosa isolates.