摘要
目的分析中南大学湘雅医院临床分离铜绿假单胞菌抗菌药物敏感性及金属酶流行情况,以期指导临床用药。方法收集2010年11月—2011年4月临床分离非重复铜绿假单胞菌200株,所有菌株均经VITEK-2全自动微生物鉴定与药敏试验分析系统进行鉴定和药敏试验。采用双纸片协同试验作为金属酶表型初筛试验,初筛阳性菌株采用聚合酶链反应(PCR)检测IMP、VIM、SPM和NDM4种金属酶基因型以及Ⅰ类整合酶基因。结果 200株铜绿假单胞菌分离自ICU患者55株,占27.5%。药敏试验结果显示,该菌对美罗培南耐药率最低(8.5%),对庆大霉素耐药率最高(38.5%)。6株铜绿假单胞菌金属酶初筛试验阳性,检出率3.0%,经基因检测发现IMP型阳性菌株2株(2株均产IMP-1菌株),未检出VIM、SPM及NDM型金属酶,且这6株铜绿假单胞菌Ⅰ类整合酶基因均为阳性。结论该院产金属β内酰胺酶的铜绿假单胞菌检出率较低,主要金属酶基因型为IMP-1。铜绿假单胞菌耐药仍较严重,但对碳青霉烯类抗生素耐药率低。
Objective The aim of this study was to investigate the antimicrobial susceptibility and the prevalence of metallo-β lactamases （MBLs） in clinical isolates of P. aeruginosa. Methods A total of 200 nonduplicate clinical isolates of P. aeruginosa were collected from November 15, 2010 to April 15, 2011 in Xiangya Hospital, Central South University. The antimicrobial susceptibility was tested by VITEK-2 automated microbial analysis system. The isolates positive in double disk synergy test were selected for PCR to identify blalMP, blaVIM, blaSPM and blaNDM genes and sequencing analysis. The positive strains then underwent examination for class I integrons by PCR with primers specific to class I integrase （IntI1）. Results The P. aeruginosa strains were primarily isolated from ICU, accounting for 27.5%. Antimicrobial susceptibility testing showed that the rate of resistance to meropenem was the lowest （8.5β）, and to gentamycin was the highest （38.5β）. Six （3.0β） iso lates harbored MBLs and 2 isolates were demonstrated by PCR. Sequence analysis revealed the presence of blaIMP-1 genes. VIM, SPM, and NDM type metal enzymes were not identified. The strains positive in phenotypic test were all positive for blaIntI1. Conclusions IMP-I is the most prevalent genotype of metallo-β-1actamase in this collection of isolates. The prevalence of metallo-β lactamase-producing P. aeruginosa is low in this hospital. The overall resistance of P. aeruginosa is serious, but they are relatively susceptible to carbapenems.
出处
《中国感染与化疗杂志》
CAS
北大核心
2013年第1期43-47,共5页
Chinese Journal of Infection and Chemotherapy
基金
湖南省科技厅科研基金资助项目(08FJ3175)
