24株洋葱伯克霍尔德菌耐药性分析及β-内酰胺酶耐药基因检测

Drug resistance of Burkholderia cepacia and its resistant genes to β-lactams

目的了解洋葱伯克霍尔德菌耐药情况及耐药基因,为临床用药提供指导。方法琼脂稀释法检测洋葱伯克霍尔德菌对10种抗生素的最低抑菌浓度(M IC);PCR法测定β-内酰胺酶耐药基因。结果洋葱伯克霍尔德菌对头孢呋辛耐药率最高,达71.5%,其次氨曲南69.9%,左旋氧氟沙星66.7%,美罗培南66.6%,氯霉素62%;耐药率最低的是米诺环素28.6%,其次头孢哌酮/舒巴坦31.6%,头孢吡肟33.3%,哌拉西林/他唑巴坦和头孢他啶分别为36.4%和40.3%。β-内酰胺酶耐药基因IMP-1和VIM-1为阳性,未检出OXA23、OXA10 OXA24、DHA1、VIM-2基因。结论洋葱伯克霍尔德菌对多种抗生素耐药率较高,临床应根据药敏结果合理选药。IMP-1和VIM-1的存在是导致洋葱伯克霍尔德菌对β-内酰胺抗生素耐药的重要机制。

Aim To investigate the change in drug resistance of Burkholderia cepacia strains and its resistant genes to β-lactams for reference of clinical antimicrobial strategy.Methods Minimum inhibitory concentrations（MIC）to 10 kinds of antimicrobial agents were detected by agar dilution method,Then,resistant genes to β-lactams were analyzed by PCR amplification.Results The highest resistant rate of Burkholderia cepacia was in cefuroxime,up to 71.5%,then in aztreonam,levofloxacin,meropenem and chloramphenicol,that is 69.9%,66.7%,66.6%and 62% respectively;the lowest resistant rate was in minocycline,only 28.6%,then in cefoperazone/sulbactam,cefepime piperacillin/tazobactam and ceftazidime which were 31.6%,33.3%,36.4%and 40% respectively.IMP gene 1 and VIM gene 1 of β-lactams were positive.OXA gene 23,OXA gene 10,OXA gene 24,DHA gene 1 and VIM gene 2 were negative.Conclusion Treatment should be guided by drug sensitivity test because the resistant rate of Burkholderia cepacia to many kinds of antimicrobial agents is higher.The existence of IMP gene 1 and VIM gene 1 are the important resistant mechanisms of Burkholderia cepacia to β-lactams antibiotics.