耐碳青霉烯类铜绿假单胞菌的耐药机制

Drug resistance mechanism of carbapenem-resistant Pseudomonas aeruginosa

目的探讨该院耐碳青霉烯类铜绿假单胞菌的耐药机制。方法采用ATB Expression进行细菌鉴定和药物敏感试验。应用PCR法对耐碳青霉烯类铜绿假单胞菌耐药基因IMP、VIM和外膜孔蛋白基因OprD2进行检测。结果 70株耐碳青霉烯类铜绿假单胞菌对多黏菌素、阿米卡星、庆大霉素耐药率分别为1.4%、47.1%、65.7%,对头孢他啶、头孢吡肟、环丙沙星的耐药率分别为64.3%、60.3%、71.4%;70株耐碳青霉烯类铜绿假单胞菌中,IMP阳性30株(42.9%)、VIM阳性13株(17.6%),膜微孔蛋白OprD2缺失70株(100.0%)。结论耐碳青霉烯类铜绿假单胞菌多重耐药情况严重。外膜孔蛋白基因OprD2的缺失是该院铜绿假单胞菌耐碳青霉烯类抗菌药物的主要机制。

Objective To investigate the drug resistance mechanism of carbapenem-resistant Pseudomonas aeruginosa in this hospital. Methods The bacterial identification and drug susceptibility testing were performed by ATB Expression. Drug resistance genes of IMP,VIM and outer membrance protein gene OprD2 in all the strains were detected by PCR. Results The resistance rate of 70 strains of carbapenem-resistant Pseudomonas to polymyxin, amikacin, gentamicin, ceftazidime, cefepime and ciprofloxacin were 1.4%,47.1%,65.7%,64.3%,60.3% and 71.4% ,respectively. Of all the strains,30 stains（42.9%） were IMP gene positive, 13 stains（17.6%） were VIM positive, 70 stains（100.0%） were OprD2 deletion. Conclusion The situation of multiple drug resistance of carbapenem-resistant Pseudomonas aeruginosa is serious. The loss of outer membrance protein gene OprD2 may be the main mechanism of carbapenem-resistantce of Pseudomonas aeruginosa.