铜绿假单胞菌的耐药现状及外膜孔蛋白分析

Antibiotic resistance analysis and investigation of oprD in imipenem-resistant pseudomonas aeruginosa

目的:总结分析我院2007年-2009年铜绿假单胞菌对常用抗生素的耐药状况,以指导临床合理选用抗生素,同时探讨外膜孔蛋白缺失介导的铜绿假单胞菌对亚胺培南的耐药机制。方法:采用PCR方法检测外膜孔蛋白OprD的编码基因,利用Whonet 5.4软件对药敏资料进行统计分析。结果:3年中铜绿假单胞菌每年的分离数量分别为132株、159株和173株,分离率分别为13.6%、14.1%和19.3%,主要分离至呼吸内科和ICU病房,标本类型则以痰液为主,474株铜绿假单胞菌对米诺环素和莫西沙星的耐药率最高,分别是89.50%和81.50%,对亚胺培南和美罗培南的耐药率分别为37.1%和34.80%,多重耐药菌株占49.50%,其中7.80%为泛耐药菌株。随机选择的8株亚胺培南耐药铜绿假单胞菌中,有一株外膜孔蛋白OprD编码基因出现缺失。结论:铜绿假单胞菌整体耐药现象比较严重,对亚胺培南的耐药率也较高;OprD的缺少是引起本组铜绿假单胞菌对亚胺培南耐药的机制之一。

Aim： To analysis the antibiotic resistance of Pseudomonas aeruginosa in our hospitalduring 2007-2009,so as to guide the using of antibiotics in hospital reasonably,and the role of OprD in imipenem-resistant Pseudomonas aeruginosa was also investigated.Methods： The the coding gene of OprD was detected with PCR.Whonet 5.4 software was used to analyze the results of drug sensitivity tests.Results： 132（13.6%）,159（14.1%） and 173（19.3%） Pseudomonas aeruginosa strains were isolated in 2007,2008 and 2009 respectively.Most of the strains were obtained from Department of Respiratory Medicine and ICU,and sputum was the main sample.Of the 474 Pseudomonas aeruginosa,resistantance rate to MH,MXF,IPM,and MEM were 89.50%,81.50%,37.1%,and 34.80%,respectively.49.50% Pseudomonas aeruginosa were multidrug resistant strains,and 7.80% strains were resistant to all the antibiotics.One of the eight random selected imipenem-resistant Pseudomonas aeruginosa did not detect OprD coding gene.Conclusion：The total antibiotic resistance of Pseudomonas aeruginosa was critical and the resistantance rate to imipenem was also high.Deletion of OprD was one of the imipenem-resistant mechanisms in Pseudomonas aeruginosa.