铜绿假单胞菌耐药性分析及分子流行病学研究

Analysis of drug resistance and molecular epidemiology study of pseudomonas aeruginosa

目的分析铜绿假单胞菌(PA)耐药现状及耐药基因情况。方法收集2009~2012年临床分离的PA 305株。K-B法进行药敏试验,并检出产ESBLs菌株及耐碳青霉烯的PA,用聚合酶链反应(PCR)对产ESBLs菌株进行TEM、SHV、CTX-M基因检测,对耐碳青霉烯PA进行VIM、IPM、OXA-23基因检测。结果3年中PA对亚胺培南、美罗培南、头孢他啶、左氧的耐药率呈上升趋势,氨曲南、阿米卡星的耐药率呈下降趋势,305株PA中共检出48株产ESBLs,57株耐碳青霉烯。PCR检测出5株PA含TEM基因,2株含SHV基因。CTX-M、VIM、IPM、OXA-23基因检测均为阴性。结论产ESBLs是我院耐药PA的重要原因,耐碳青霉烯的PA不含VIM、IPM、OXA-23基因。

Objective To analyze the resistance of pseudomonas aeruginosa （PA） and its resistant genes. Methods The clinical isolates of PA were collected from 2009 to 201 I. Drug sensitivity test was done by K-B meth- od to detect the isolates producing ESBLs and resistance to carbapenem. Polymerase chain reaction （PCR） was used to detect resistant genes that were TEM, SHV, CTX-M ,VIM, IPM, and OXA-23 gene. Results PA showed a ris- ing resistance to meropenem, imipenem, ceftazidime, levofloxacin, and the resistance to aztreonam and amikacin showed a decrease trend. There were 48 strains of PA producing ESBI,s, and 57 strains resistant to carhapenem. There were 5 strains of PA containing TEM gene and 2 strains with SHV gene detected hy PCR. CTX-M, VIM, IPM, and OXA-23 genes were negative through this detection. Conclusion The important mechanism of high resistance of PA is ESBLs, and PA resistant to carbapenem do not contain ~1M, IPM, and OX^t-23 genes.