江苏省苏州地区儿童铜绿假单胞菌的流行特征及耐消毒基因检测

Epidemiological characteristics and antiseptic resistance gene detection of Pseudomonas aeruginosa in children in Suzhou,Jiangsu Province

目的了解江苏省苏州地区儿童铜绿假单胞菌感染的临床分布特征、耐药趋势、耐消毒剂基因携带情况,以期为儿童铜绿假单胞菌感染的防护与治疗提供理论依据。方法回顾性分析2016—2021年苏州大学附属儿童医院分离得到的853株铜绿假单胞菌的临床分布特点、耐药趋势,并随机选取其中101株菌株,采用聚合酶链式反应法检测9种耐消毒基因(qacEΔ1-sul1、qacE、qacEΔ1、qacG、sugE(p)、sugE©、emrE、ydgE、ydgF)的表达情况。结果铜绿假单胞菌主要来源于呼吸道标本(47.83%)、脓液(28.60%)、尿液(11.72%);主要来源科室是重症监护室(21.45%)、普外科(15.71%)、呼吸科(12.31%);患者年龄以1个月~1岁和大于6岁为主(分别是34.31%和25.38%)。铜绿假单胞菌的耐药率排名前三依次为亚胺培南(11.25%),氨曲南(9.26%),美罗培南(8.02%)。在853株铜绿假单胞菌中,耐药菌株主要来自于重症监护室(58/183)、血液科(33/91)、新生儿科(31/96),多重耐药菌株有57株,检出率为6.68%。对碳青霉烯类耐药的铜绿假单胞菌菌株有98株(11.49%),2016—2021年检出率分别为22.06%、8.40%、3.60%、5.67%、9.85%、17.20%。9种耐消毒基因中ydgF携带率高达98.02%,sugE©携带率有94.06%,qacE携带率为0。结论铜绿假单胞菌对部分药物产生较高的耐药性,应注意合理用药。有2种耐消毒基因携带率超过90%,应加强消毒剂耐药机制研究,合理使用消毒剂。

Objective To investigate the clinical distribution characteristics,drug resistance trends and the carrying of antiseptic resistance gene of Pseudomonas aeruginosa infection in children in Suzhou,in order to provide theoretical basis for the prevention and treatment of Pseudomonas aeruginosa infection in children.Methods The clinical distribution characteristics and drug resistance trends of Pseudomonas aeruginosa isolated from Children's Hospital of Soochow University from 2016 to 2021 were retrospectively analyzed.Forthermore,101 strains of Pseudomonas aeruginosa were randomly selected to detect the expression of 9 antiseptic resistance genes(qacEΔ1-sul1,qacE,qacEΔ1,qacG,sugE(p),sugE©,emrE,ydgE,ydgF)by polymerase chain reaction.Results Pseudomonas aeruginosa in Soochow University Children's Hospital was mainly isolated from respiratory specimen(47.83%),pus(28.60%)and urine(11.72%);the main departments were intensive care unit(21.45%),general surgery department(15.71%)and respiratory department(12.31%).Patients were mainly aged from 1 month to 1 year old and older than 6 years old(34.31%and 25.38%).The top three drug resistance rates of Pseudomonas aeruginosa were imipenem(11.25%),aztreonam(9.26%)and meropenem(8.02%).Among the 853 strains of Pseudomonas aeruginosa,the drug-resistant strains were mainly from the intensive care unit(58/183),hematology department(33/91),neonatology department(31/96),and there were 57 strains of multi-drug-resistant strains with the detection rate of 6.68%.There were 98 strains(11.49%)of Carbapenem resistant Pseudomonas aeruginosa,and the annual detection rates were 22.06%,8.40%,3.60%,5.67%,9.85%and 17.20%,respectively.Among the 9 antiseptic resistance genes,the carrying rate of ydgF,sugE©and qacE was 98.02%,94.06%and 0 respectively.Conclusion Pseudomonas aeruginosa has high resistance to some drugs,so attention should be paid to rational drug use.The carriage rates of of two antiseptic resistance genes exceeded 90%,indicating the need to strengthen research on the mechanism of antiseptic resistance research and rational use of disinfectants.