铜绿假单胞菌对碳青霉烯类抗生素的耐药机制研究进展

铜绿假单胞菌（Pa）是临床最常见的条件致病菌,尤其是在医院获得性感染中占有非常重要的地位,但近年来随着碳青霉烯类抗生素的广泛应用,耐碳青霉烯类的铜绿假单胞菌株逐渐增多。据拉丁美洲抗生素监测组资料显示,亚胺培南的敏感性由1997年的77．1％降至2001年的62．2％,美罗培南由83．0％降至64．4％。PATZER等报道显示,1986—1992年临床分离的Pa菌株中耐亚胺培南株仅为1．8％,1994年至1996年耐亚胺培南株为2．6％,     

铜绿假单胞菌对碳青霉烯类抗生素耐药相关基因的筛选

为了在基因组水平筛选获得铜绿假单胞菌PAO1对碳青霉烯类抗生素耐药相关基因,本研究通过构建PAO1转座突变体文库、筛选对亚胺培南、美罗培南和比亚培南耐药及敏感突变株;通过随机PCR、核苷酸测序及序列比对的手段,确定了突变体中转座子的插入位点及其破坏的基因,获得了48个PAO1中对碳青霉烯类抗生素耐药和敏感相关的基因,其中27个基因突变后表现为耐药性增强,21个基因突变后表现为药物敏感性增强.本实验筛选获得的48个基因中有5个与Alvarez-Ortega和Dotsch等人筛选的基因重复.通过对PA0011,PA0667及PA3901进行基因敲除及遗传互补,进一步确证这3个基因均与PAO1对碳青霉烯类的耐药性相关.本次筛选发现了38个新的与碳青霉烯类耐药相关的基因,其中包括13个class4类基因.对这些新基因的进一步研究,不仅有利于全面了解铜绿假单胞菌的耐药机制及其调控网络,而且有利于药物作用靶点的发现,为有效治疗铜绿假单胞菌的感染提供新思路.     

铜绿假单胞菌对喹诺酮类药物耐药机制的研究进展

铜绿假单胞菌是一种重要的医院内感染条件致病菌,喹诺酮类药物是一类主要用于革兰阴性菌感染的抗菌药物。随着该类药物的广泛使用,该菌的耐药率也逐年上升。大量的研究表明,该菌对喹诺酮类药物的耐药机制主要包括：①编码喹诺酮类药物作用靶位的DNA旋转酶和拓扑异构酶Ⅳ的基因突变,改变了酶的结构,使药物不能与酶－DNA复合物稳定结合;②外排系统调节基因的变异而导致细胞内药物浓度降低。     

亚胺培南耐药铜绿假单胞菌耐药机制的研究

目的探讨铜绿假单胞菌对碳青霉烯类抗生紊的耐药机制。方法应用铜绿假单胞菌外膜蛋白SDS-PAGE图谱、凝胶分光光度扫描分析方法和三维试验分析亚胺培南耐药铜绿假单胞菌外膜蛋白和β-内酰胺酶类型。结果耐药组OprD2相对含量显著低于敏感组。耐药组产生了较高活性的AmpC酶。结论铜绿假单胞菌对亚胺培南的耐药机制可能是OprD2的缺失和AmpC酶共同作用的结果。     

铜绿假单胞菌异质性耐药的研究进展

异质性耐药是指细菌中的同源亚群对某种抗生素表现出不同的敏感性,被认为是细菌由敏感进化成完全耐药的中间阶段.常规的临床检验无法有效检测出异质性耐药,这对临床治疗用药造成了巨大的威胁,引起患者的反复感染和用药失败.铜绿假单胞菌作为医院内感染的主要条件致病菌之一,其耐药机制已被广泛研究,而异质性耐药研究则相对较少.本文主要就...     

铜绿假单胞菌对青霉素类抗生素异质性耐药研究

【背景】铜绿假单胞菌是临床上常见的条件致病菌,其异质性耐药的发生常导致临床治疗失败。【目的】研究铜绿假单胞菌对青霉素类抗生素的异质性耐药情况,为相关临床感染治疗提供一定的依据。【方法】收集临床分离的50株铜绿假单胞菌,采用纸片扩散法(diskdiffusion method)即Kirby-Bauer (K-B)法、菌落谱型分析(population analysis profile,PAP)法、生长实验以及传代稳定性实验探究铜绿假单胞菌的异质性耐药特征。【结果】K-B法初筛得到铜绿假单胞菌对哌拉西林(piperacillin,PIP)、哌拉西林/他唑巴坦(piperacillin/tazobactam,TZP)和替卡西林/克拉维酸(ticarcillin/clavulanic acid,TIM)的异质性耐药率分别为52%、52%和54%。PAP实验确认后有13株异质性耐药菌,其检出率占总实验菌株的26%。随机选取8株异质性耐药菌株,其耐药亚群的发生频率为7.3×10-7-1.2×10-5。通过无抗生素压力的生长实验发现,异质性耐药菌株PAS92、PAS57与其各自的3株最高PIP浓度平...     

对一株铜绿假单胞菌22种耐药基因的研究

目的研究铜绿假单胞菌多重耐药情况和相关机制。方法采用聚合酶链反应（PCR）法对一株多重耐药铜绿假单胞菌进行β-内酰胺酶基因、氨基糖苷类修饰酶（AMEs）基因、喹诺酮类耐药基因、耐消毒剂基因（qacE△1-sul1）和整合酶基因检测,并对VIM基因进行了测序。结果PCR扩增结果显示该菌株aac（6′）-Ⅰb、blaCARB、gyrA、oprD2、ant（2″）-Ⅰ、qacE△1-sul1、blaIMP-I、blaTEM、blaVEB、aac（3）-Ⅱ、ant（3″）-Ⅰ、intⅠ1、blaVIM基因均为阳性,而aac（3）-Ⅰ、aac（6′）-Ⅱ、blaGES、blaGIM、blaOXA-10群、blaPER、blaSPM、blaSHV、blaDHA基因均为阴性,VIM基因扩增产物测序后经BLAST同源性分析表明为VIM-2型。结论铜绿假单胞菌存在多重耐药基因。管壁涂有季胺类、双胍类消毒剂和磺胺的II代导管的抑菌效果需重新评价。     

CIP耐药的铜绿假单胞菌两种分子耐药机制关系的研究

目的探讨环丙沙星（CIP）耐药的铜绿假单胞菌临床分离株主动外排药物与gyrA、parC基因突变的关系。方法联合碳酰氰基-对-氯苯腙（CCCP）和CIP对CIP耐药的铜绿假单胞菌株进行主动外排阳性株和阴性株的筛选,并对这些菌株的gyrA,parC基因进行聚合酶链式反应-限制性片段长度多态性分析（PCR—RFLP）。结果57％（55／97）的CIP耐药菌株最小抑菌浓度（MIC）可被逆转,gyrA单基因突变率为65％,gyrA和pa-C双基因突变率为35％,未发现parC单基因突变的菌株。主动外排阳性组与阴性组gyrA、parC基因突变情况差异无显著性。结论在本地区铜绿假单胞菌对CIP的耐药机制中,主动外排系统表达上调与抗菌药物作用靶位的改变均占有重要的地位,两者可能是并存的两种相对独立的机制。     

耐亚胺培南铜绿假单胞菌金属酶的筛选及基因型研究

目的研究重庆医科大学附属第一医院分离的29株耐亚胺培南铜绿假单胞菌中金属酶（Metallo-β-Lactamase,MBL）的基因型分布情况。方法用亚胺培南-EDTA纸片法筛选29株铜绿假单胞菌中产MBL的铜绿假单胞菌,用PCR扩增法检测29株菌中金属酶VIM和IMP基因。结果29株耐亚胺培南的铜绿假单胞菌中,亚胺培南-EDTA纸片法筛选出MBL阳性菌株5株,阳性率为17％。PCR扩增出IMP基因型有4株,阳性率为14％,均为金属酶IMP-9型,未扩增出VIM基因。以PCR法结果为判定标准,亚胺培南-EDTA纸片法敏感性100％,特异性96％。结论IMP-9型为该院分离的这29株耐亚胺培南的铜绿假单胞菌中主要MBL基因型。本实验中所用的亚胺培南一EDTA纸片法能简单有效的筛选出产MBL的铜绿假单胞菌。     

耐亚胺培南铜绿假单胞菌相关耐药基因的检测

目的对耐亚胺培南（IMP）的铜绿假单胞菌（IRPa）相关耐药基因进行检测。方法 2003年至2009年从临床标本中分离到（P.aeruginosa）共220株,采用三维试验筛选产β-内酰胺酶的铜绿假单胞菌,应用普通PCR和多重PCR分别检测碳青霉烯酶基因和质粒携带的C类头孢菌素酶（AmpC酶）耐药基因,应用荧光定量RT-PCR的方法检测oprD2基因的表达情况。结果共检出43株产β-内酰胺酶的菌株,其中产AmpC酶、超广谱β-内酰胺酶（ESBLs）、金属β-内酰胺酶（MBLs）和未知酶菌株的构成比分别58.14%（25/43）、18.60%（8/43）、4.65%（2/43）和16.28%（7/43）。74株耐亚胺培南的铜绿假单胞菌中,有2株菌携带IMP-9基因,1株菌携带DHA质粒型AmpC酶基因,其他碳青霉烯酶基因检测为阴性。40株菌株oprD2基因表达蛋白量降低,34株oprD2基因表达蛋白量正常。结论 oprD2基因的突变或蛋白表达量降低是IRPa对亚胺培南耐药的主要原因,AmpC酶可水解亚胺培南可能与铜绿假单胞菌对亚胺培南的耐药有一定的关系,而KPC-1酶和MBLs在铜绿假单胞菌对亚胺培南耐药机制中不是主要因素。     

铜绿假单胞菌外膜蛋白缺失合并qacE△12sul1与耐药性的研究

目的 对临床分离的54株铜绿假单胞菌(Pseudomonas aeruginosa,PAE)进行耐药基因检测,分析的PAE耐药性,为临床合理用药提供依据.方法 应用MIC法和K-B法检测PAE对22种药物的耐药性,采用PCR法检测PAE的消毒剂磺胺类qacE△12sul1基因和外膜蛋白oprD2基因,并对阳性菌株进行序列分析.结果 54株PAE中oprD2膜缺失、qacE△12sul1、多重耐药铜绿假单胞菌(Multi-drug Resistant of Pseudomonas aeruginosa,MRPA)菌株的检出率分别为77.8％、14.8％、37.0％;20株MRPA菌株中,qacE△12sul1、oprD2膜缺失阳性率分别为40.0％、50.0％;54株PAE对氨苄西林和头孢唑啉完全耐药,对头孢呋辛钠、头孢呋辛酯、复方新诺明的耐药率均为98.1％、对多粘菌素B敏感率为100％;MRPA与非MRPA对qacE△12sul1基因阳性菌株的检出率差异有统计学意义;oprD2阴性和阳性菌株对亚胺培南和美洛培南的耐药率差异有统计学意义.结论 临床分离的铜绿假单胞菌耐药严重,oprD2基因的缺失可能是亚胺培南和美洛培南耐药的主要原因.     

Role for rpoS gene of Pseudomonas aeruginosa in antibiotic tolerance

The alternative sigma factor, RpoS has been described as a central regulator of many stationary phase-inducible genes and a master stress-response regulator under various stress conditions. We constructed an rpoS mutant in Pseudomonas aeruginosa and investigated the role of rpoS gene in antibiotic tolerance. The survival of the rpoS mutant cells in stationary phase was approximately 70 times lower when compared with that of the parental strain at 37 degrees C for 2 h after the addition of biapenem. For imipenem, the survival was approximately 40 times lower. Heat stress promoted an increase in the survival of the parental strain to biapenem, but the same was not found to be the case for the rpoS mutant. Our results indicate that rpoS gene is involved in tolerance to antibiotics in P. aeruginosa during the stationary phase and heat stress. However, under osmotic stress, tolerance to biapenem was not dependent on the rpoS gene.     

A second tonB gene in Pseudomonas aeruginosa is linked to the exbB and exbD genes

The exbBD genes of Pseudomonas aeruginosa PAO were cloned by complementation of the growth defect of an Escherichia coli exbB tolQ double mutant on iron-restricted medium. Nucleotide sequence analysis confirmed that these genes are contiguous and preceded by a second tonB gene in this organism, which we have designated tonB2. lacZ promoter fusions confirmed that expression of the tonB2-exbB-exbD genes is increased under conditions of iron limitation. Deletions within any of these genes, in contrast to deletions in the first tonB gene, tonB1, did not adversely affect growth on iron-restricted medium. On the other hand, tonB1 tonB2 double mutants were more compromised as regards growth in an iron-restricted medium than a tonB1 deletion, indicating that TonB2 could partially replace TonB1 in its role in iron acquisition. TonB1 but not TonB2 deletion strains were also compromised as regards the utilization of hemin or hemoglobin as sole iron sources, indicating that heme transport requires TonB1.     

Gene cloning and expression of the Pseudomonas aeruginosa periplasmic phosphate-binding protein

Abstract The pstS gene, encoding the Pseudomonas aeruginosa phosphate-binding protein, was cloned onto a cosmid vector into Escherichia coli , and localized by subcloning, mapping the insertion site of Tn 501 in a P. aeruginosa pstS ::Tn 501 mutant, and hybridization to an oligonucleotide pool synthesized according to the aminoterminal amino acid sequence of the purified protein. The cloned pstS gene was transferred to P. aeruginosa pstS mutants. The P. aeruoginosa phosphate-binding protein was also expressed and secreted into the periplasm of E. coli pstS mutants.     

携带armA基因的铜绿假单胞菌耐药性及基因周边环境

目的 了解多重耐药(MDR)铜绿假单胞菌armA基因与可移动遗传元件的携带情况及其相关性;分析armA基因的周边环境, 探讨armA基因转移的可能机制。 方法 收集MDR铜绿假单胞菌98株,琼脂稀释法测定MIC,PCR方法检测16S rRNA甲基化酶基因armA、I型整合子、可移动元件IS26及重要耐药基因侧翼基因环境,测序并拼接PCR产物明确耐药基因座位排列,并对armA基因进行周边序列分析。 结果 98株MDR铜绿假单胞菌检出5株armA基因PCR扩增阳性,携带armA基因的菌株对庆大霉素和阿米卡星全耐药;检出20株携带I型整合子,17株携带可移动元件IS26;armA基因扩增阳性的菌株均携带I型整合子和IS26;序列测序显示armA定位于Tn1548相关区域,位于插入序列ISCR1的下游,该序列含多种移动元件。 结论 大连市氨基糖苷类高水平耐药基因armA广泛分布在MDR铜绿假单胞菌中,均对庆大霉素和阿米卡星高度耐药;该基因定位在转座子Tn1548的质粒上,提示16S rRNA甲基化酶基因armA的广泛播散可能是可移动元件ISCR1 armA IS26结构参与其中。     

The Synergistic Effect of Visible Light and Gentamycin on Pseudomona aeruginosa Microorganisms

Recently there were several publications on the bactericidal effect of visible light, most of them claiming that blue part of the spectrum (400 nm-500 nm) is responsible for killing various pathogens^1-5. The phototoxic effect of blue light was suggested to be a result of light-induced reactive oxygen species (ROS) formation by endogenous bacterial photosensitizers which mostly absorb light in the blue region^4,6,7. There are also reports of biocidal effect of red and near infra red⁸ as well as green light⁹.In the present study, we developed a method that allowed us to characterize the effect of high power green (wavelength of 532 nm) continuous (CW) and pulsed Q-switched (Q-S) light on Pseudomonas aeruginosa. Using this method we also studied the effect of green light combined with antibiotic treatment (gentamycin) on the bacteria viability. P. aeruginosa is a common noscomial opportunistic pathogen causing various diseases. The strain is fairly resistant to various antibiotics and contains many predicted AcrB/Mex-type RND multidrug efflux systems¹⁰.The method utilized free-living stationary phase Gram-negative bacteria (P. aeruginosa strain PAO1), grown in Luria Broth (LB) medium exposed to Q-switched and/or CW lasers with and without the addition of the antibiotic gentamycin. Cell viability was determined at different time points. The obtained results showed that laser treatment alone did not reduce cell viability compared to untreated control and that gentamycin treatment alone only resulted in a 0.5 log reduction in the viable count for P. aeruginosa. The combined laser and gentamycin treatment, however, resulted in a synergistic effect and the viability of P. aeruginosa was reduced by 8 log''s.The proposed method can further be implemented via the development of catheter like device capable of injecting an antibiotic solution into the infected organ while simultaneously illuminating the area with light.