摘要
目的探讨碳青霉烯类耐药的铜绿假单胞菌同源性及其主要耐药机制。方法收集临床标本946份,分离出碳青霉烯类耐药的铜绿假单胞菌,采用琼脂稀释法进行体外药物敏感性试验;采用肠杆菌基因间重复一致序列为引物的聚合酶链反应(ERIC-PCR)进行耐药菌株同源性分析;筛选其金属β-内酰胺酶并测定主动外排系统表型来分析碳青霉烯类耐药的铜绿假单胞菌的耐药性。结果共检测出75株碳青霉烯类耐药的铜绿假单胞菌;ERIC-PCR同源性分析显示75株菌株共分为8个型别,其中A型占34.7%(26株)、B型占22.7%(17株);75株碳青霉烯类耐药的铜绿假单胞菌中有13株为产酶株,产酶率为17.3%;外排泵抑制剂MC207110可以使34株美罗培南耐药株的最低抑菌浓度(MIC)较单药时下降4倍或以上,占63.0%。结论本院分离的耐碳青霉烯类铜绿假单胞菌主要有两种类型,产生碳青霉烯水解酶和外排泵机制是碳青霉烯类耐药铜绿假单胞菌耐药的重要机制。
Objective To investigate the homology and main drug resistance mechanism of carbapenem-resistant Pseudomonas aeruginosa. Methods A total of 946 samples were collected,and carbapenem-resistant Pseudomonas aeruginosa were isolated. The drug sensitivity of carbapenem-resistant Pseudomonas aeruginosa were detected by agar dilution test. Enterobacterial repetitive intergenic consensus-polymerase chain reaction（ ERIC-PCR） was performed to analyze homology. The isolates were screened by metallo-beta-lactamae. The efflux pump of Pseudomonas aeruginosa resistant to carbapenem antibiotics was detected by efflux pump inhibitor test. Results A total of 75 isolates of carbapenem-resistant Pseudomonas aeruginosa were isolated. The ERIC-PCR homology analysis showed 8 types,in which A-type and B-type were the main types,accounting for 34. 7%（ 26 isolates） and 22. 7%（ 17 isolates）,respectively. In the 75 isolates resistant to carbapenems,13 isolates were positive in metal enzyme test,accounting for17. 3%. MC207110 efflux pump inhibitor could make the minimal inhibitory concentration（ MIC） of meropenem in 34 isolates being resistant to meropenem decreasing by 4 times or more,compared with single drug therapy,accounting for63. 0%. Conclusions There are mainly 2 kinds of cloning existing in Pseudomonas aeruginosa being resistant to carbapenem. The production of metallo-beta-lactamase and multi-drug resistant efflux system play important roles in the drug resistance of Pseudomonas aeruginosa.
出处
《检验医学》
CAS
2014年第7期755-759,共5页
Laboratory Medicine
