糖尿病足患者感染铜绿假单胞菌携带β-内酰胺类耐药基因的流行趋势研究

Trend ofβ-lactam resistance genes of Pseudomonas aeruginosa isolated from diabetic foot infections

目的研究糖尿病足感染(diabetic foot infective,DFI)患者分离的铜绿假单胞菌(PAE)β-内酰胺类抗菌药物耐药表型和基因型,对超广谱β-内酰胺酶耐药基因的流行趋势做初步探讨。方法留取2009年11月-2011年1月住院治疗的209例糖尿病足感染患者足部深组织样本,对分离出的41株PAE进行DNA检测,以聚合酶链反应检测耐药基因,结合药敏试验报告结果,进行耐药基因型和表型分析。结果耐药PAE中14株携带OXA-10群占34.15%,2株携带SHV基因占4.88%,1株同时携带DHA、OXA-10群和CARB占2.44%,其他基因均未检出;13株表现oprD2基因缺失型占31.71%;具有耐药表型34株占82.92%,20株对3种以上头孢菌素耐药占58.82%,7株对抗菌药物全敏感占17.07%。结论天津地区DFI耐药菌株携带OXA-10及其基因突变衍生型较多,可能是流行特点之一。

OBJECTIVE To study the drug-resistant phenotypes and genotypes of Pseudomonas aeruginosa（PA）strains from diabetic foot infective patients and investigate beta-lactam antibiotic resistance genes of these PAE isolates so as to make a preliminary discussion of the trend ofβ-lactam resistance genes.METHODS The samples of foot deep tissue of 209 patients with diabetic foot admitted from Nov.2009 to Jan.2011 were collected.DNA detection was conducted to the 41 strains of PAE isolated from those samples.Drug resistant genes were detected by PCR.And drug resistant genotypes and phenotypes were analyzed according to drug sensitivity test reports.RESULTS In drug resistant PAE strains,14 carried OXA-10（34.15%）and 2carried SHV（4.88%）and 1strain carried both DHA,OXA-10 and CARB（2.44%）.Among them,13 strains were found to be lack of oprD2（31.71%）and 34 strains were with drug resistance phenotypes（82.92%）.Totally 20 strains were resistant to over 3 kinds of cephalosporin（58.82%）. There were 7 strains sensitive to all antibiotics（17.07%）.CONCLUSIONThe most predominant genes response to beta-lactam antibiotic resistance of the PAE isolates in Tianjin are OXA-10 and its derivatives.