摘要
目的检测2004-2008年临床分离铜绿假单胞菌对亚胺培南的耐药性,并探讨其耐药机制。方法采用K-B法检测临床分离铜绿假单胞菌对抗菌药物的敏感性,采用PCR方法检测碳青酶烯酶基因和外膜通道蛋白基因。结果 2004-2008年共分离铜绿假单胞菌1947株,耐亚胺培南的菌株573株,耐药率29.4%;2006-2008年与2004-2005年相比耐亚胺培南的铜绿假单胞菌有上升趋势,从14.4%上升到31.8%;耐亚胺培南的铜绿假单胞菌中以阿米卡星最敏感,其次为头孢他啶和头孢哌酮/舒巴坦,哌拉西林/他唑巴坦的敏感率下降明显;23株耐亚胺培南的铜绿假单胞菌IMP基因阳性4株(17.4%),VIM基因阳性4株(17.4%),OprD2缺失18株(79.3%)。结论耐亚胺培南铜绿假单胞菌携带多种金属酶基因,但主要是由于外膜通道蛋白基因OprD2缺失引起,阿米卡星与头孢他啶或头孢哌酮/舒巴坦联合是有效的治疗手段。
OBJECTIVE To investigate the imipenem resistant Pseudornonas aeruginosa in our hospital from 2004 to 2008 and understand the distribution of resistance-imipenem gene. METHODS The suscepibility to antibotics of P. aeruginosa was detected by Kirby Bauer method. β- lactamase gene and the outer membrane channel protein gene were determinated by using PCR method. RESULTS Of 1947 clinical P. aeruginosa isolates, 29.4% were resistant to imipenem. The The resistance-imipenem rate of the P. aeruginosa strains was higher 100% in 2006-2008 than 2004 2005, from 14.4% to 31.8%. Imipenem-resistant P. aeruginosa isolates showed the lowest resistance rate to amikacin, the lower rate were ceftazidime and cefoperazone/sulbactam. Resistant rate of Piperacillin/ tazobactam to P. aeruginose increaed quikly. The positive rates of blaIMP, blaVIM were 17.4%, 17.4% ,respectively. The absent rate of OprD2 was 79.3 %. CONCLUSIONS Imipenem-resistant P. aeruginosa isolated in our hospital havd carried resistant genes encoding β-lactamases. The loss of OprD2 gene play an important role in this mechanism. Combination therapy of ceftazidime or cefoperazone/sulbactam plus amikacin is usually indicated for infection by P. aeruginosa.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第12期1654-1656,共3页
Chinese Journal of Nosocomiology
