耐亚胺培南铜绿假单胞菌的耐药性及超广谱β-内酰胺酶的基因分析

The antibiotic-resistance and its gene analysis of extended-spectrum β-lactamases in imipenem-resistant Pseudomonas aeruginosa

目的:探讨临床分离铜绿假单胞菌的药敏谱及其产超广谱β-内酰胺酶(ESBLs)的情况、基因分布和流行特性。方法:分析208株铜绿假单胞菌对16种抗生素的药敏谱,筛选耐亚胺培南铜绿假单胞菌,采用PCR检测ESBLs基因(TEM、SHV、OXA-10、OXA-2、PER、VEB)。结果:53株对亚胺培南耐药,耐药率为25.48%(53/208),且对头孢替坦(CTE)、头孢唑林(CZ)、氨苄西林/舒巴坦(AMS)、呋喃妥因(FTN)等耐药率较高;53株亚胺培南耐药菌经PCR检测,产ESBLs菌株23株,其中TEM型16株,OXA-10型4株,PER型3株,未检测出OXA-2和SHV型。结论:耐亚胺培南铜绿假单胞菌中产ESBLs菌株的基因型主要为TEM型,且为多重耐药,临床应结合药敏谱,合理使用抗生素。

Objective ：To investigate the antimicrobial susceptibility of Pseudomonas aeruginosa and extended-spectrum β-lactamase （ESBLs） producing condition, gene distribution and epidemiological characteristics in clinic. Methods ： The antimicrobial susceptibility was detected with the Vitek-2 compact automatic bacteria identification system, 16 antibiotics for 208 Pseudomonas aeruginosa isolated. The imipenem-resistant Pseudomonas aeruginosa were selected. ESBLs genes produced by imipenem resistance were detected by PCR, the ESBLs genes contain TEM, SHV, OXA-10, OXA-2, PER and VEB. Results： In the 208 isolates, 53 strains of Pseudomonas aeruginosa were resistant to imipenem, the drug resistance rate was 25.48%. The isolates had a high rate of drug-resistance against CTE, CZ, AMS and FTN; The PCR results showed that in the 53 imipenem-resistant Pseudomonas aeruginosa, ESBLs gene were produced in 23 strains, 16 strains were TEM,4 for OXA-10 and 3 for PER gene;OXA-2, SHV was not detected. Conclusions：TEM of Extended-spectrum β-lactamase producing in imipenem-resistant Pseudomonas aeruginosa is the main gene in our hospital, most of them are multi-drug-resistance, detecting the antimicrobial susceptibility and using antibiotics rationally is essential in clinic.