重症监护病房患者铜绿假单胞菌IMP-1耐药基因检测及其耐药性分析

Detection of IMP-1 drug-resistance gene in Pseudomonas aeruginosa and its drug-resistance analysis

目的:探讨重症监护病房(intensive care unit,ICU)患者铜绿假单胞菌IMP-1耐药基因检测及耐药性,为临床合理使用抗生素提供依据。方法:采用聚合酶链反应(PCR)检测耐药基因IMP-1,ATB Expression自动鉴定病原菌及药敏分析。结果:2007～2009年共分离出106株铜绿假单胞菌,对头孢他啶、亚胺培南、哌拉西林、氨曲南、头孢哌酮、头孢吡肟、左氧氟沙星的耐药率分别为50.9%、39.6%、79.2%、56.6%、57.5%、41.5%、25.5%。每年耐亚胺培南株的检出率依序分别为16.0%、28.3%、39.6%。耐亚胺培南株绝大部分检出IMP耐药基因。结论:ICU患者金属酶表型阳性菌株检出的基因型主要为IMP-1,产酶菌株耐药性强,随时进行细菌耐药性监测,正确使用有效的抗生素是控制感染和延缓细菌耐药的关键。

Objective：To detect the IMP-1 drug-resistance gene of Pseudomonas aeruginosa and to analyze its drug-resistance to provide evidence for rational antibiotics use.Methods：PCR was used to determine the genes of IMP-1 and ATB expression was used to identify pathogens and test drug sensitivity.Results：106 strains of Pseudomonas aeruginosa were isolated during 2007-2009.The resistant rates to ceftazidime,imipenem,piperacillin,aztreonam,cefoperazone,cefepime,levofloxacin were as follows：50.9%,39.6%,9.2%,56.6%,57.5%,41.5% and 25.5% respectively.Especially the annual detection rates of imipenem-resistant strain were 16.0%,28.3% and 39.6% from 2007 to 2009 respectively.Conclusion：The majority of metallo-β-lactamases-producing genotype IMP-1 are determined from Pseudomonas aeruginosa in ICU.these stains should be monitored closely in clinical treatment.The proper use of effective antibiotics is the key to control infection and delay bacterial drug-resistance.