铜绿假单胞菌整合子检测与耐药性相关性研究

Study on relationship between integron genes and drug resistance of Pseudomonas aeruginosa

目的调查本院临床分离的铜绿假单胞菌(PA)中整合子的分布情况,分析整合子携带与菌株耐药的关系。方法用VITEK 2 Compact全自动微生物分析仪对细菌进行鉴定和药敏分析,采用PCR方法检测PA中I、Ⅱ、Ⅲ类整合子基因携带情况。结果 249株PA中,检测出I类整合子阳性94株,占37.7%,未检测出Ⅱ类、Ⅲ类整合子。药敏试验结果显示,PA对氨苄西林(98.8%)、头孢唑啉(98.8%)、头孢曲松(98.8%)和复方新诺明(88.4%)耐药现象比较严重;头孢吡肟、头孢他啶、丁胺卡那霉素、庆大霉素、妥布霉素、亚胺培南和环丙沙星的耐药率较低。I类整合子阳性菌株对除氨苄西林、头孢唑啉、头孢曲松、复方新诺明外的其他抗菌药物的耐药率明显高于I类整合子阴性菌株,差异均有统计学意义(P<0.01)。结论 I类整合子广泛存在于本院分离的铜绿假单胞菌中,在耐药基因传播中起着重要作用,院内感染和临床应引起足够的重视。

Objective To investigate the prevalence of integrons in clinical isolates of Pseudomonas aeruginosa and analyze the relationship between the presence of integrons and antibiotic resistance. Methods VITEK 2 Compact analyzer was used for the identification and susceptibility testing of clinical isolates,and PCR was used for the detection of integrons prevalence ofⅠ,Ⅱ,Ⅲ integrons in PA. Results Among 249 clinical isolates of Pseudomonas aeruginosa,type Ⅰ integron was detected in 94 isolates（ 37. 7%）,and typeⅡand Ⅲ integrons were not detected. Pseudomonas aeruginosa were high resistant to ampicillin（ 98. 8%）,cefazolin（ 98. 8%）,ceftriaxone（ 98. 8%）,trimethoprim（ 88. 4%）,and low resistant to cefepime,ceftazidime,piperacilin sodium/tazobactam sodium,amikacin,gentamicin,tobramycin. The resistance rates to most of antibiotics were significantly higher in integron I-positive isolates than in integron I-negative ones except ampicillin,cefazolin,ceftriaxone,trimethoprim,with the differences statistically significant（ P〈 0. 01）. Conclusion Pseudomonas aeruginosa with typeⅠintegron is widely distributed in hospital isolates and plays an important role in the spread of resistance genes,which should be paid sufficient attention to.