耐亚胺培南铜绿假单胞菌耐药特征及其耐药机制的研究

发布时间：2018-11-26 15:26

【摘要】：目的探讨耐亚胺培南铜绿假单胞菌耐药特征及其耐药机制。方法选取2013年12月-2015年8月本院临床送检标本分离的40株耐亚胺培南铜绿假单胞菌,采用全自动微生物分析仪对其进行细菌鉴定,并采用纸片扩散法对其进行药敏试验,聚合酶链反应(PCR)检测碳青霉烯酶相关基因(IMP、VIM、OXA、GES)及外膜蛋白基因oprD,分析其耐药特征以及耐药机制。结果耐亚胺培南铜绿假单胞菌对阿米卡星的耐药率最低,为8.26%;对庆大霉素、妥布霉素的耐药率在20%以下;对环丙沙星、左氧氟沙星、哌拉西林、他唑巴坦、舒巴坦的耐药率在40%~60%之间;对头孢他啶、头孢曲松、头孢吡肟、氨曲南、美罗培南、复方磺胺甲VA唑、米诺环素等抗菌药物的抗菌活性较差,耐药率均在60%以上;而对氨苄西林全部耐药。40株耐亚胺培南铜绿假单胞菌中检测出1株OXA-17阳性菌株,阳性率为2.50%;检测出oprD2基因缺失菌株13株,缺失率为32.50%;未检测出IMP、VIM以及GES等其他耐药基因。结论临床上应该重视和加强对细菌耐药性的监测,合理地应用低耐药的抗菌药物,以减少耐药菌株的产生。
[Abstract]:Objective to investigate the drug resistance of imipenem resistant Pseudomonas aeruginosa and its mechanism. Methods from December 2013 to August 2015, 40 strains of imipenem resistant Pseudomonas aeruginosa were selected and identified by automatic microbiological analyzer. Polymerase chain reaction (PCR) was used to detect carbapenase associated gene (IMP,VIM,OXA,GES) and outer membrane protein gene (oprD,). Results the resistance rate of imipenem resistant Pseudomonas aeruginosa to amikacin was the lowest (8.26%), and to gentamicin, tobramycin was below 20%. The resistance rates of ciprofloxacin, levofloxacin, piperacillin, tazobactam and sulbactam were between 40% and 60%; The antimicrobial activity of ceftazidime, ceftriaxone, cefepime, aztreonam, meropenem, compound sulfamethoxazole and minocycline was poor, and the resistance rate was over 60%. In 40 strains of imipenem resistant Pseudomonas aeruginosa, 1 OXA-17 positive strain was detected, the positive rate was 2.50%, 13 strains of oprD2 gene deletion strain were detected, and the deletion rate was 32.50%. No other resistant genes such as IMP,VIM and GES were detected. Conclusion We should pay attention to and strengthen the monitoring of bacterial drug resistance in clinic and use low drug resistance antibiotics reasonably in order to reduce the production of drug resistant strains.
【作者单位】：济南市儿童医院;
【分类号】：R446.5

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