摘要
目的了解临床分离耐亚胺培南铜绿假单胞菌(Imipenem-resistant Pseudomonas aeruginosa,IPMRPa)及其耐药特征,探讨该菌产金属酶和相关基因blaVIM-2对抗菌药物耐药性的影响。方法收集3年临床分离铜绿假单胞菌,采用MIC法测定抗生素耐药性;用复合纸片法筛查IPMRPa产金属β-内酰胺酶的菌株;聚合酶链反应(PCR)法对金属酶相关基因(blaVIM-2)检测并测序确定。结果 1426株铜绿假单胞菌中IPMRPa为910株(63.8%),均为多重耐药;非IPMRPa的516株(36.2%)中仅有71株多重耐药,两者的多重耐药率比较有显著性差异(P<0.05)。在IPMRPa与非IPMRPa的耐药性比较中发现:除四环素外的其他测试抗生素耐药率均有显著差异(P<0.05)。910株IPMRPa中经复合纸片法检出产金属β-内酰胺酶168株,占18.6%(168/910);168株采用PCR扩增出135株(80.4%,135/168)携带有blaVIM-2型基因,扩增产物经序列分析均为VIM-2型。结论 IPMRPa多重耐药现象严重,VIM-2型金属酶基因型在产金属β-内酰胺酶的IPMRPa菌株中检出率高,但该基因并不是产金属酶的铜绿假单胞菌对本研究中12种测试抗菌药物耐药的主要原因。
Objective To understand Imipenem-resistant Pseudomonas aeruginosa（IPMRPa） and its drug- resistance, study the metallo-^-lactamase and the influence of relative gene VIM-2 on drug resistance. Methods Antibiotic sensibility tests were analyzed by MIC, producing metallo-β-lactamase IPMRPa strains were screened by mixed K-B method. VIM-2 gene was detected by PCR. Results 910 IPMRPa （63.8%） were all multi-drug resistance, whereas among 516 non-IPMRPa（36.2%） strains, multi-drug resistant stains ,gas only 71 stains. Hence it had significant difference （P〈0.05）. Comparative analyses between IPMRPa and non-IPMRPa strains, apart from tetracycline, the drug resistance of other antibiotics detected had significant difference （P〈0.05）. The positive ratio of metallo-β-lactamase produced strains was 18.6%（168/910）. blawM.2 gene was detected by PCR, and the positive ratio was 80.4%（135/168）. Conclusion IPMRPa has strong multi-drug resistance. VIM-2 metallo-β-lactamase has higher positive ratio, but this gene is not the main reason about Pseudomonas aeruginosa produced metallo-β-lactamase strains to the drug resistance with all 12 antibiotics detected exclusive of IPM.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2012年第7期507-509,527,共4页
Chinese Journal of Antibiotics
