耐亚胺培南铜绿假单胞菌产金属β-内酰胺酶的检测及其耐药性分析(1)
[摘要] 目的 探讨该院耐亚胺培南铜绿假单胞菌产金属β-内酰胺酶的检测方法，并了解该地区耐亚胺培南铜绿假单胞菌产金属β-内酰胺酶的耐药特征，为该院对铜绿假单胞菌的控制提供依据。方法 方便选取65例2017年7月—2018年12月在该院住院治疗的患者的标本，临床分离了65株铜绿假单胞菌，对其进行菌种的鉴定和药物的敏感试验。采用E-test试验对金属酶进行检测，采用PCR法扩增产金属β-内酰胺酶的基因，并进一步测序确认扩增的阳性产物。结果 65株铜绿假单胞菌的标本中以呼吸道分泌物最多，占比81.54%(53株)，在分布上呼吸内科、ICU病房比较高，分别占了总数的33.85%(22株)和36.92%(24株)。药敏试验结果显示，有18株(27.69%)铜绿假单胞菌对亚胺培南耐药，并且大多为多重耐药菌株;E-test试验结果显示，阳性金属酶4株，检出率为22.22%;PCR法扩增金属酶基因阳性3株(4.62%)，其中IMP-1和VIM-2分别为3株和1株。结论 该地区耐亚胺培南的18株銅绿假单胞菌中大多为多重耐药菌株，产金属β-内酰胺酶在铜绿假单胞菌对亚胺培南的耐药中发挥着极其重要的作用，并且IMP-1和VIM-2为酶的主要基因型。
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[关键词] 亚胺培南;铜绿假单胞菌;产金属β-内酰胺酶;耐药性;基因型;药敏试验;PCR法
[中图分类号] R378.99 [文献标识码] A [文章编号] 1674-0742(2019)09(c)-0178-03
[Abstract] Objective To investigate the detection method of metallo-β-lactamase produced by imipenem-resistant Pseudomonas aeruginosa in the hospital， and to understand the metallo-β-lactamase production by imipenem-resistant Pseudomonas aeruginosa in the region. The drug resistance characteristics provide a basis for the control of Pseudomonas aeruginosa in the hospital. Methods A total of 65 specimens of patients hospitalized in the hospital from July 2017 to December 2018 were conveniently selected. 65 strains of Pseudomonas aeruginosa were isolated and identified for their strains and drug sensitivity tests. The metalloenzyme was detected by the E-test test， and the gene for producing metal β-lactamase was amplified by PCR， and further amplified to confirm the positive product. Results Of the 65 strains of Pseudomonas aeruginosa， the respiratory secretions were the most， accounting for 81.54% (53 strains). The distribution of upper respiratory medicine and ICU wards was relatively high， accounting for 33.85% (22 strains) and 36.92% (24 strains). The results of drug susceptibility test showed that 18 strains (27.69%) of Pseudomonas aeruginosa were resistant to imipenem， and most of them were multi-drug resistant strains; E-test test results showed that 4 positive metalloenzymes， detection rate was 22.22%; 3 strains (4.62%) were positive for metalloenzyme gene by PCR， among which IMP-1 and VIM-2 were 3 strains and 1 strain， respectively. Conclusion Most of the 18 strains of Pseudomonas aeruginosa resistant to imipenem in the region are multi-drug resistant strains. The production of metal β-lactamase plays an important role in the resistance of Pseudomonas aeruginosa to imipenem. The role of IMP-1 and VIM-2 is the major genotype of the enzyme., 百拇医药(张雪松)
, http://www.100md.com
[关键词] 亚胺培南;铜绿假单胞菌;产金属β-内酰胺酶;耐药性;基因型;药敏试验;PCR法
[中图分类号] R378.99 [文献标识码] A [文章编号] 1674-0742(2019)09(c)-0178-03
[Abstract] Objective To investigate the detection method of metallo-β-lactamase produced by imipenem-resistant Pseudomonas aeruginosa in the hospital， and to understand the metallo-β-lactamase production by imipenem-resistant Pseudomonas aeruginosa in the region. The drug resistance characteristics provide a basis for the control of Pseudomonas aeruginosa in the hospital. Methods A total of 65 specimens of patients hospitalized in the hospital from July 2017 to December 2018 were conveniently selected. 65 strains of Pseudomonas aeruginosa were isolated and identified for their strains and drug sensitivity tests. The metalloenzyme was detected by the E-test test， and the gene for producing metal β-lactamase was amplified by PCR， and further amplified to confirm the positive product. Results Of the 65 strains of Pseudomonas aeruginosa， the respiratory secretions were the most， accounting for 81.54% (53 strains). The distribution of upper respiratory medicine and ICU wards was relatively high， accounting for 33.85% (22 strains) and 36.92% (24 strains). The results of drug susceptibility test showed that 18 strains (27.69%) of Pseudomonas aeruginosa were resistant to imipenem， and most of them were multi-drug resistant strains; E-test test results showed that 4 positive metalloenzymes， detection rate was 22.22%; 3 strains (4.62%) were positive for metalloenzyme gene by PCR， among which IMP-1 and VIM-2 were 3 strains and 1 strain， respectively. Conclusion Most of the 18 strains of Pseudomonas aeruginosa resistant to imipenem in the region are multi-drug resistant strains. The production of metal β-lactamase plays an important role in the resistance of Pseudomonas aeruginosa to imipenem. The role of IMP-1 and VIM-2 is the major genotype of the enzyme., 百拇医药(张雪松)