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目的了解大连地区分离的耐亚胺培南铜绿假单胞菌的耐药特征,金属β-内酰胺酶携带情况,提供大连地区院内控制铜绿假单胞菌感染的依据。方法选取2013年1月至2014年9月临床分离的400株铜绿假单胞菌,进行菌种鉴定和药物敏感试验;金属酶检测采用E-test试验;PCR法扩增产金属β-内酰胺酶的基因,并对扩增阳性产物进行测序确认。结果 400株铜绿假单胞菌的标本以呼吸道分泌物最多,占81.5%;分布以呼吸内科和ICU病房最高,占总数的19.8%和25.5%;药敏结果发现有89株铜绿假单胞菌对亚胺培南耐药,且多数为多重耐药菌株;400株铜绿假单胞菌经E-test试验进行金属酶表型筛查,有17株金属酶阳性,检出率为19.1%;经PCR扩增金属酶基因阳性的有11株,其中8株为IMP-1,3株为VIM-2,其他几种基因均未检出。结论大连地区耐亚胺培南的89株铜绿假单胞菌多数是多重耐药菌株;产金属β-内酰胺酶在大连地区铜绿假单胞菌对亚胺培南耐药中发挥重要作用,酶的基因型主要为IMP-1和VIM-2。
Objective To understand the drug resistance of isolated strains of imipenem-resistant Pseudomonas aeruginosa in Dalian and the carrying status of metal β-lactamase, so as to provide a basis for in-hospital control of Pseudomonas aeruginosa infection in Dalian. Methods 400 strains of Pseudomonas aeruginosa clinically isolated from January 2013 to September 2014 were selected for strain identification and drug susceptibility testing. E-test was used to detect metalloenzyme and β-lactamase Enzyme gene, and amplified products were confirmed by sequencing. Results The samples of 400 Pseudomonas aeruginosa strains accounted for 81.5% of the total respiratory tract secretions. The distribution was respiratory medicine and ICU wards, accounting for 19.8% and 25.5% of the total, respectively. Drug susceptibility results showed that 89 strains of Pseudomonas aeruginosa Resistant to imipenem, and most of them were multidrug-resistant strains. 400 strains of Pseudomonas aeruginosa were screened by E-test for the phenotype of metalloproteinase, 17 of them were positive, the detection rate was 19.1%. 11 were positive for PCR amplification of metalloenzyme genes, of which 8 were IMP-1 and 3 were VIM-2, and none of the other genes were detected. CONCLUSION: Most of the 89 strains of Pseudomonas aeruginosa in imipenem-resistant area in Dalian are multidrug-resistant strains. Metallo-β-lactamase plays an important role in the resistance of imipenem to Pseudomonas aeruginosa in Dalian. Enzymatic genotypes were mainly IMP-1 and VIM-2.