摘要
目的了解临床分离耐亚胺培南铜绿假单胞菌（irnipenem-resistant Pseudomonas aeruginosa, IMPRPA）的耐药特征，探讨该菌产金属β-内酰胺酶及其相关基因VIM-2对抗菌药物耐药性的影响。方法收集3年临床分离的铜绿假单胞菌（Pseudomonas aeruginosa，PA）共1426株，采用MIC法测定抗生素耐药性；用复合纸片法筛查IMPRPA产金属β-内酰胺酶的菌株；聚合酶链反应（polymerase chain reaction，PCR）法对金属酶相关基因VIM-2进行检测并测序确定。采用SPSS11．5统计软件对数据进行统计学分析。结果1426株PA中，IMPRPA为910株（63．8％），非IMPRPA为516株（36.2％）；IMPRPA对12种抗生素的耐药率除四环素外，均显著高于非IMPRPA，差异均有统计学意义（P均〈0．05）。910株IMPRPA均为多重耐药株，多重耐药率为63．8％，显著高于非IMPRPA的5．0％（71株），差异具有统计学意义（P〈0．05）。910株IMPRPA中检出产金属β-内酰胺酶168株，占18．5％（168／910）；168株IMPRPA采用PCR扩增，检出135株IMPRPA（80．4％，135／168）携带有blaVIM-2型基因。结论IMPRPA耐药性强，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IMPRPA菌株中检出率高，但该基因并不是PA产余属B-内酰胺酶对12种抗菌药物耐药的宅要原因。
Objective To investigate the antibiotic resistance status in imipenem-resistant Rseu-domonas aeruginosa（IMPRPA）, and to analyze the affect to antibiotics from metalloenzyme and VIM-2 of IMPRPA. Methods 1426 strains IMPRPA were collected by clinical in 3 years. The drug resistant status of Pseudomonas aeruginosa （PA） was detected by MIC tests. Composite paper method used to screening metallo-β-1actamase of IMPRPA. Metallo-β-1actamase VIM-2 gene was detected by PCR. All data were analyzed by SPSS 11.5 statistical software. Results There were 910 strains IMPRPA （63.8%） and 516 strains non-IM- PRPA （36.2%） in 1426 strains PA. The drug resistant rates of IMPRPA were all higher than non-IMPRPA to 12 antibiotics, except tetracycline. And there were statistical significance in the differences between them （Pall〈 0.05 ）. 910 strains IMPRPA were all multi drug resistant PA （63.8%）. It was higher than non-IMPRPA （71 strains, 5.0%）, and there was statistical significance in the difference between them （P〈 0.05）. 168 strains IMPRPA were positive in metallo-13-1actamase （18.5%, 168/910）, and there were 135 strains carried VIM-2 gene （80.4%, 135/168）. Conclusion The multi drug resistant status of IMPRPA was severe. VIM-2 gene detection rate is high in product metallo-β-1actamase IMPRPA,but the VIM-2 gene is not the main reason of multi drug resistance.
出处
《实用检验医师杂志》
2012年第2期92-95,共4页
Chinese Journal of Clinical Pathologist
