铜绿假单胞菌的耐药性及耐药基因研究

The drug resistance and drug resistance genes of Pseudomonas aeruginosa

目的分析临床分离铜绿假单胞菌的耐药性,检测耐药基因,探讨耐药基因与耐药性的关系。方法采用美国德灵Microscan WalkAway 40系统对病原菌进行鉴定及药敏试验;采用PCR扩增技术对临床分离铜绿假单胞菌耐药性相关基因TEM、CARB、OXA-10、VIM、VEB、IMP、DHA、aac(6′)-Ⅰb、aac(6′)-Ⅱ、ant(2′)-Ⅰ、qacE△1-sul1、oprD2进行检测。结果 67株铜绿假单胞菌耐药严重,对哌拉西林/他唑巴坦、哌拉西林、替卡西林/克拉维酸的耐药率达100.0%;检出TEM、CARB、OXA-10、aac(6′)-Ⅰb、aac(6′)-Ⅱ、ant(2′)-Ⅰ、qacE△1-sul1、VIM、VEB基因,检出阳性率分别为98.6%、82.1%、88.1%、92.6%、92.6%、71.7%、83.6%、13.4%、1.5%,未检出IMP、DHA基因。结论β-内酰胺酶耐药是多机制联合作用的结果,氨基糖苷类修饰酶基因的高检出率与铜绿假单胞菌对氨基糖苷类的耐药关系有待进一步探讨,医院分离铜绿假单胞菌对季铵类、双胍类消毒剂耐药。

OBJECTIVE To detect the relationship between drug resistance genes and drug resistance of P. aerugi- nosa isolated from patients with analyzing the drug resistance and probing the drug resistance genes. METHODS Microscan WalkAway 40 system was used to detect the genes and carry on the drug sensitive test. The resistance genes TEM, CARB, OXA-10, VIM, VEB, IMP, DHA, aac（6′）- Ⅰ b, aac（6′）- Ⅱ , ant（2′）- Ⅰ , qacE△1-sul1 and oprD2 were determined by polymerase chain reaction（PCR）. RESULTS The drug resistance of 67 strains P. aeruginosa was serious, which was 100. 0K resistance to piperacillin/tazobactam, piperacillin, ticarcillin/clavu- lanicacid, the positive rates of TEM, CARB, OXA-10, VIM, VEB, aac（6′）- Ⅰb, aac（6′）- Ⅱ , ant（2′）- Ⅰ , qacEfl-sull, and oprD2 were 98.6%, 82.1%, 88. 1%, 92.6%, 92.6%, 71.7% and 83.6%, 13.4%, and 1.5 %, respectively. The gene of IMP and DHA were not detected. CONCLUSION The P. aeruginosa were not sensitive to β-1actams because of the combined effect of multi-mechanism. Relations between high detection rate of aminoglycosides modifying enzymes （AMEs） genes and P. aeruginosa resistance to aminoglycoside antibiotics should have further investigation. Most of the P. aeruginosa separated from our hospital were highly resistant to quaternary amine and biguanides disinfectant.