多重耐药铜绿假单胞菌氨基糖苷类修饰酶基因研究

Study of aminoglycosides modification gene in multidrug-resistant Pseudomonas aeruginosa

目的:了解铜绿假单胞菌氨基糖苷类修饰酶基因存在情况,为耐药性监测提供依据。方法:采用VITEK-32配套GNS-448及K-B法测定铜绿假单胞菌对抗菌药物的敏感性,采用聚合酶链反应及序列分析的方法分析氨基糖苷类修饰酶基因类型。结果:20株多重耐药铜绿假单胞菌对亚胺培南、美洛培南全部耐药,哌拉西林/他唑巴坦、头孢吡肟及头孢他啶的耐药率分别为90.0%、100%和85%,氨基糖苷类抗生素的耐药率为阿米卡星85.0%、庆大霉素100%,对其他抗菌药物的耐药率均在85.0%以上。20株铜绿假单胞菌中检出5株aac(6)′-Ⅰb、1株aac(6)′-Ⅱ、15株ant(3)′-Ⅰ、8株ant(2)′-Ⅰ,阳性率分别为25%、5%、75.0%、40%。其他基因型阴性。结论:本院重症监护病房临床分离的铜绿假单胞菌多重耐药严重,氨基糖苷类修饰酶基因携带率较高。

Objective：To get a general idea about the existence of the aminoglycosides modification gene in multidrug-resistant Pseudomonas aeruginosa strains collected from the patients in ICU（intensive care unit） and give the theory supporting of the drug resistance monitoring.Methods：Using VITEK-32 matched with GNS-448 and KB method to detect the sensitivities of Pseudomonas aeruginosa strains to the antibiotics,adopting polymerase chain reaction and sequence analysis methods to typing the aminoglycosides modification genes.Results：Among the 20 Multidrug-Resistant Pseudomonas aeruginosa strains being detected,there were 100.0% of them resistant to Imipenem and Meroperem;90.0% to Piperacillin /Tazobactam;100% to Cefepime;85.0% to Ceftazidime;85.0% to Amikacin,100% to Cidomycin in aminoglycoside antibiotics;above 85.0% to other antibiotics.aac（6′）-Ⅰb was found in 5 strains,possessing 25% positive ratio;aac（6′）-Ⅱin 1,5%;ant（3′）-Ⅰin 15,75.0%;ant（2′）-Ⅰin 8,40%.Other genetypes were not found.Conclusion：Pseudomonas aeruginosa strains are multidrug-resistant seriously,taking aminoglycosides modification gene with a high proportion in ICU of our hospital.