耐亚胺培南铜绿假单胞菌的临床分离及耐药机制分析(1)
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[摘要] 目的：了解我院耐亚胺培南铜绿假单胞菌(IRPA)的临床分布情况，并探讨其耐药机制。方法：对2009年1月～2010年12月我院住院患者临床分离的非重复性IRPA的数据资料进行统计分析，采用PCR方法检测金属酶基因和外膜通道蛋白基因。结果：从404株铜绿假单胞菌中共分离出100株IRPA，分离率为24.75%。其中90株(90.0%)IRPA来源于下呼吸道痰液标本；IRPA主要来源于重症医学科(ICU)；IRPA对阿米卡星最敏感率为73.0%(耐药率为27.0%)，其次是哌拉西林/他唑巴坦(敏感率为63.0%)，哌拉西林(敏感率为59.0%)，庆大霉素(敏感率为58.0%)，头孢他啶(敏感率为57.0%)，其余药物的敏感率均<50.0%。仅1株IRPA检测出IMP基因阳性(1.0%)，测序为IMP-9型金属酶基因，其余金属酶基因均未检出；oprD2基因缺失的IRPA有65株(65.0%)。结论：我院IRPA主要是由于外膜通道蛋白oprD2缺失引起，且已有IMP-9型IRPA在我院流行，需引起重视。
[关键词] 铜绿假单胞菌；亚胺培南；耐药性
[中图分类号] R378 [文献标识码] B [文章编号] 1673-7210(2011)12(b)-092-03
Clinical distribution and antimicrobial resistance mechanism of Imipenem-resistant pseudomonas aeruginosa
LIAN Jie1, MAI Liwen1, YU Zhijian2, DENG Qiwen2*
1.Department of Centrel Laboratory, Nanshan Hospital Affiliated to Guangdong Medical College, Guangdong Province, Shenzhen 518052, China; 2.Department of Infectious Disease, Nanshan Hospital Affiliated to Guangdong Medical College, Guangdong Province, Shenzhen 518052, China
[Abstract] Objective: To investigate the clinical distribution and antimicrobial resistance mechanism of Imipenem-resistant pseudomonas aeruginosa (IRPA). Methods: Data on non-recurrent IRPA isolated from inpatients of this hospital from Janaury 2009 to December 2010 were statistically analyzed. β-lactamase gene and the outer membrane channel protein gene were determinated by using PCR method. Results: 404 strains of P. aeruginosa, 100 strains were resistant to Imipenem, indicating that IRPA was isolated at a rate of 24.75%. Of these strains, 90 strains (90.0%) were primarily isolated from sputum. IRPA originated primarily in ICU. The lowest drug resistance was to Amikacin (27.0%), followed by Piperacillin/Tazobactam (63.0%), Piperacillin (59.0%), Gentamicin (58.0%), Ceftazidime (57.0%), the rates of drug resistance to the other antibiotics were less than 50.0%. Only one strain of IRPA was detected positive by IMP gene (1 ......
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