铜绿假单胞菌抗生素耐药性及耐药相关基因检测

目的了解2011-2012年深圳市南山区医院患者,各医院诊所内环境、医护人员手涂抹样以及食品样中铜绿假单胞菌（Pseudomonas aeruinosa,PA）对抗生素耐药性及携带耐药基因情况。方法利用VITEK 2 compact全自动微生物鉴定仪对PA菌进行药敏试验。采用聚合酶链反应（polymeras chain reaction,PCR）技术检测PA的20种耐药基因：β-内酰胺TEM、VEB、CARB、OXA、SHV、PER、GES、GTX、SPM、GIM,金属β-内酰胺酶IMP、VIM,AmpC酶DHA,膜通道蛋白oprD,氨基糖苷类修饰酶Aac（6’）-Ⅰ、Aac（6’）-Ⅱ、Aac（3’）-Ⅰ、Aac（2’）-Ⅰ,耐消毒基因qacE1-sull与Ⅰ类整合子基因。结果药敏试验显示53株菌对11种抗菌药物阿米卡星、氨苄西林等耐药率为100%,对呋喃妥因、亚胺培南等耐药率为10%~30%。检出11种耐药基因：TEM、SHV、IMP、DHA、Aac（6’）-Ⅰ、Aac（6’）-Ⅱ、Aac（3’）-Ⅰ、Aac（2’’）-Ⅰ、qacE1-sull、Ⅰ类整合子及oprD基因,检出率分别为7.54%、5.66%、3.77%、11.32%、5.66%、15.09%、5.66%、58.49%、9.43%和9.43%,oprD基因缺失率为67.93%。结论部分分离自患者菌株呈多重耐药,且携带多种耐药基因,应引起高度重视。不同类型样本分离菌株携带耐药基因存在差异。

Detection on antibiotic-resistance and antibiotic-resistant genes of Pseudomonas aeruinosa

Objective To learn the antibiotic-resistance and antibiotic-resistant genes of Pseudomonas aeruinosa（ PA） from inpatients,smear samples of hospital and clinic environment,smear samples of medical staff’s hands and foods in Nanshan District of Shenzhen in 2011 and 2012. Methods Antibiotic resistance of PA strains from different samples were detected by VITEK 2 compact apparatus and the 20 kinds antibiotic-resistant genes（ TEM,VEB,CARB,OXA,SHV,PER,GES,GTX,SPM,GIM,IMP,VIM,DHA,oprD,Aac（ 6’）-I,Aac（ 6’）-II,Aac（ 3’）-I,Aac（ 2’）-I,qacE1-sull and int-I） were detected by polymeras chain reaction（ PCR）. Results The antibiotic resistance rate was 100% to Amikacin and Ampicillin etc,while 10% to 30% to Nitrofurantoin and Imipenem etc. 11 resistant genes,including TEM,SHV,IMP,DHA,Aac（ 6’）-I,Aac（ 6’）-II,Aac（ 3’）-I,Aac（ 2’）-I,qacE1-sull,int-I and oprD,were detected,and the positivity rates were 7.54%,5.66%,3.77%,11. 32%,5. 66%,15. 09%,5. 66%,58. 49%,9. 43% and 9. 43%,respectively; the loss rate of oprD gene was 67. 93%. Conclusion The PA strains from patients showed multi-drug resistance and carried multiple resistant genes. These findings suggest that it is important to strengthen the monitoring on multi-drug resistant Pseudomonas aeruginosa. There are some differences in the resistant genes carried by PA strains from different samples.