铜绿假单胞菌对抗菌药物敏感率的变化趋势及耐碳青霉烯菌外膜通道蛋白OprD2基因检测

发布时间：2018-12-10 13:12

【摘要】：目的:了解贵阳市某三甲医院2011年1月至2014年12月铜绿假单胞菌的临床感染分布及对常用抗生素的耐药情况,为临床合理使用抗生素提供参考并探究耐碳青霉烯类铜绿假单胞菌耐药性和外膜通道蛋白Opr D2的关系。方法:采用WHONET 5.6软件对4年间铜绿假单胞菌的标本来源、感染科室及耐药情况进行回顾性分析。收集2011-2015年临床分离的非重复耐亚胺培南铜绿假单胞菌共148株,PCR扩增外膜通道蛋白基因Opr D2。结果:(1)耐药结果显示:4年间,铜绿假单胞菌对环丙沙星和左氧氟沙星的耐药率最高,对阿米卡星的耐药率最低。4年共分离出铜绿假单胞菌2 125株,以呼吸道标本、分泌物标本及尿液标本为主,其中呼吸道标本在铜绿假单胞菌的分离率最高。临床感染科室主要集中在外科、内科以及ICU,其中ICU分离株耐药率高于其他科室。(2)PCR结果显示:148株标本中,有98株菌株Opr D2缺失,缺失率为66%。结论:该院铜绿假单胞菌耐药率较高,ICU病房高于普通病房。该院铜绿假单胞菌耐药率虽然有逐年下降的趋势,但是其耐药情况依旧很严峻。外膜通道蛋白Opr D2基因的缺失可能是该院耐亚胺培南铜绿假单胞菌耐药的主要耐药机制之一。
[Abstract]:Objective: to investigate the clinical infection distribution and antibiotic resistance of Pseudomonas aeruginosa in a third Class A Hospital of Guiyang City from January 2011 to December 2014. To provide reference for rational use of antibiotics and to explore the relationship between resistance of carbapene-resistant Pseudomonas aeruginosa and Opr D2. Methods: the samples of Pseudomonas aeruginosa, infection department and drug resistance were analyzed retrospectively by WHONET 5.6 software. A total of 148 strains of non-repeated imipenem resistant Pseudomonas aeruginosa isolated from 2011 to 2015 were collected, and Opr D2 gene was amplified by PCR. Results: (1) the drug resistance rates of Pseudomonas aeruginosa to ciprofloxacin and levofloxacin were the highest, and those to amikacin were the lowest. Secretion samples and urine samples were mainly isolated, and the respiratory tract samples were the most isolated from Pseudomonas aeruginosa (Pseudomonas aeruginosa). The clinical infection departments mainly focus on surgery, internal medicine and ICU,. The drug resistance rate of ICU isolates is higher than that of other departments. (2) the results of PCR showed that 98 out of 148 samples were Opr D2 deletion, and the deletion rate was 66.1%. Conclusion: the drug resistance rate of Pseudomonas aeruginosa was higher in our hospital, and the rate of drug resistance in ICU ward was higher than that in general ward. Although the resistance rate of Pseudomonas aeruginosa decreased year by year, the drug resistance of Pseudomonas aeruginosa was still very serious. The deletion of Opr D2 gene may be one of the main drug resistance mechanisms of imipenem resistant Pseudomonas aeruginosa.
【作者单位】：贵州医科大学;贵州医科大附属医院;贵阳市第一人民医院;
【基金】：贵州医科大学附属医院博士启动基金贵州省卫计委科学技术基金项目(编号:gzwjkj2014-2-019) 国家教学团队(编号:教高函[2009]18号) 高等学校特色专业建设点(编号:教高函[2010]15号)
【分类号】：R446.5

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