我国铜绿假单胞菌耐氨基糖苷类基因分布的文献研究

Distribution of Aminoglycoside-resistant Genes in Pseudomonas aeruginosa in China: A Literature Study

目的了解我国铜绿假单胞菌的氨基糖苷类耐药基因分布状况。方法计算机检索CBM、CNKI、VIP和WanFang Data数据库,收集报道我国铜绿假单胞菌耐氨基糖苷类基因的研究,检索时限均从建库至2012年12月。由2位评价员按照纳入与排除标准筛选文献、提取资料后,采用SPSS 17.0软件进行统计分析。结果共纳入10个省市1 144株耐氨基糖苷类铜绿假单胞菌。氨基糖苷类修饰酶基因aac(3’)-Ⅰ、aac(3’)-Ⅱ、aac(6’)-Ⅰ、aac(6’)-Ⅱ、ant(2’’)-Ⅰ、ant(3’’)-Ⅰ和aph(3’)-Ⅵ在淮河以北地区的检出率分别为13.3%、40.1%、21.6%、40.3%、38.1%、23.7%和2.9%,而淮河以南地区的检出率分别为3.2%、20.2%、15.9%、37.6%、28.3%、28.5%和9.1%。16S rRNA甲基化酶基因rmtA、rmtB和armA检出率分别为20.4%、19.4%和0.7%,而其余16S rRNA甲基化酶基因均未检出。结论氨基糖苷类修饰酶是我国铜绿假单胞菌耐氨基糖苷类药物的主要机制,而16S rRNA甲基化酶是其次要机制。

Objective To get a picture of the distribution of aminoglycoside-resistant genes in pseudomonas aeruginosa in China. Methods We electronically searched CBM, CNKI, VIP and WanFang Data for studies that reported aminoglycoside-resistant genes in pseudomonas aeruginosa in China from inception to December 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria, and extracted data. Then statistical analysis was performed using SPSS 17.0 software. Results A total of 1 144 strains of aminoglycoside-resistant pseu- domonas aeruginosa from 10 provinces/cities were included. The positive rates of aac（3＇）-I, aac（3＇）-II, aac（6＇）-I, aac（6＇）-II, ant（2＂＇）-I, ant（3＂）-I and aph（3＇）-VI of aminogfycoside modifying enzyme genes were 13.3%, 40.1%, 21.6%, 40.3%, 38.1%, 23.7% and 2.9%, respectively to the north of Huai River, while the rates were 3.2%, 20.2%, 15.9%, 37.6%, 28.3%, 28,5% and 9.1%, respectively to the south of Huai River. The positive rates of rmtA, rmtB and armA of 16S rRNA methylases genes were 20.4%, 19.4% and 0.7%, respectively, while other 16S rRNA methylases genes were not found. Conclusion In China, aminoglycoside modifying enzyme is the primary mechanism of pseudomonas aeruginosa aminoglycoside-resistant drugs, while 16S rRNA methylation enzyme mechanism is secondary.