基层医院铜绿假单胞菌耐药基因检测

Detection of drug resistance genes of Pseudomonas aeruginosa in primary hospital

目的对聊城市二级医院临床分离的铜绿假单胞菌耐药机制进行研究,为指导基层临床用药提供参考依据。方法收集医院2015年4-12月分离出的铜绿假单胞菌30株,其中22株为亚胺培南耐药株,8株为亚胺培南敏感株;所有菌株均经手工鉴定和K-B法药敏试验。结果 OprD2基因缺失21株,OprM阳性22株,mexB阳性24株,VIM阳性24株,OXA-10阳性1株,intⅠ-1阳性8株,qacE△1-sul1阳性8株,mucB阳性24株,IMP、OXA-23、MucA三个耐药基因未检出。结论铜绿假单胞菌耐药机制主要与细菌产VIM型金属β-内酰胺酶、细胞主动外排机制以及膜微孔蛋白基因OprD2缺失、生物膜形成有关,Ⅰ类整合子标志物也是铜绿假单胞菌流行的原因之一。

OBJECTIVE To investigate the drug resistance mechanism of Pseudomonas aeruginosa isolated from a second-level hospital in Liaocheng city, so as to provide references for clinical medicine in primary hospitals. METHODS Totally 30 strains of P. aeruginosa were collected in the hospital from Apr. 2015 to Dec. 2015,inclu- ding 22 strains of imipenem-resistant strains and 8 strains of imipenem-sensitive strains. All strains were identified by manual method and were tested by K-B method in drug sensitivity test. RESULTS There were 21 strains of OprD2 gene deletion, 22 strains of OprM positive, 24 strains of mexB positive, 24 strains of VIM positive, 1 strain of OXA-IO positive , 8 strains of int Ⅰ -1 positive, 8 strains of qacE△1-sull positive, 24 strains of rnucB positive, and three resistance genes of IMP, OXA-23, and MucA were not detected. CONCLUSION The drug re- sistance mechanism of P. aeruginosa mainly relate to the metallo-βl-lactamase gene VIM, active efflux mechanism, membrane protein gene OprD2 deletion, and biofilm formation. Class Ⅰ integrons plays a key role in the preva- lence of P..aeruginosa.