黏液型铜绿假单胞菌耐药特征和耐药株相关基因型分析

Analysis of drug resistance and genotype of drug-resistant strains of mucoid Pseudomonas aeruginosa

目的探讨携带不同基因型黏液型铜绿假单胞菌与抗菌药物耐药性的相关性,为临床合理使用抗菌药物治疗携带不同基因型黏液型铜绿假单胞菌提供理论参考依据。方法 110株铜绿假单胞菌通过药敏试验和PCR方法检测。结果与24h药敏结果相比,48h黏液型铜绿假单胞菌对亚胺培南和美罗培南的耐药率均为13.6%,而对阿米卡星、妥布霉素、庆大霉素、头孢吡肟、哌拉西林/他唑巴坦、左氧氟沙星和头孢他啶的耐药率在6.4%～11.8%,差异有统计学意义(P<0.05)。携带AmpC阳性基因的菌株有12株(80.00%),携带VIM-2阳性基因的菌株有9株(60.00%),携带OprD2阴性基因的菌株有11株(73.33%)。结论不同时间检测的黏液型铜绿假单胞菌对亚胺培南和美罗培南耐药率显著不同,其机制与AmpC、VIM-2和OprD2基因密切相关。

Objective To explore the correlation between different genotypes of mucoid Pseudomonas aeruginosa and antimicrobial resistance,and to provide theoretical reference for clinical rational use of antimicrobial agents to carry different genotypes of mucoid Pseudomonas aeruginosa.Methods Totally 110 strains of Pseudomonas aeruginosa were tested by drug sensitivity test and PCR method.Results Compared with 24-hour susceptibility test,the resistance rates of 48-hour mucinous Pseudomonas aeruginosa to imipenem and meropenem were 13.6%,while those to amikacin,tobramycin,gentamicin,cefepime,piperacillin/tazobactam,levofloxacin and ceftazidime were 6.4%-11.8%,which had significant difference(P<0.05).There were 12 strains(80.00%)carrying AmpC positive gene,9 strains(60.00%)carrying VIM-2 positive gene and 11 strains(73.33%)carrying OprD2 negative gene.Conclusion The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were significantly different at different time.The mechanism was closely related to the genes of AmpC,VIM-2 and OprD2.