耐亚胺培南铜绿假单胞菌的临床分离及耐药机制分析.docx

耐亚胺培南铜绿假单胞菌的临床分离及耐药机制分析[摘要]目的：了解我院耐亚胺培南铜绿假单胞菌（IRPA）的临床分布情况并探讨其耐药机制。方法：对2009年1月～2010年12月我院住院患者临床分离的非重复性IRPA的数据资料进行统计分析采用PCR方法检测金属酶基因和外膜通道蛋白基因。结果：从404株铜绿假单胞菌中共分离出100株IRPA分离率为24.75%。其中90株（90.0%）IRPA来源于下呼吸道痰液标本；IRPA主要来源于重症医学科（ICU）；IRPA对阿米卡星最敏感率为73.0%（耐药率为27.0%）其次是哌拉西林/他唑巴坦（敏感率为63.0%）哌拉西林（敏感率为59.0%）庆大霉素（敏感率为58.0%）头孢他啶（敏感率为57.0%）其余药物的敏感率均[关键词]铜绿假单胞菌；亚胺培南；耐药性[中图分类号]R378[文献标识码]B[文章编号]1673-7210（2011）12（b）-092-03ClinicaldistributionandantimicrobialresistancemechanismofImipenem-resistantpseudomonasaeruginosaLIANJie1MAILiwen1YUZhijian2DENGQiwen2*1.DepartmentofCentrelLaboratoryNanshanHospitalAffiliatedtoGuangdongMedicalCollegeGuangdongProvinceShenzhen518052China;2.DepartmentofInfectiousDiseaseNanshanHospitalAffiliatedtoGuangdongMedicalCollegeGuangdongProvinceShenzhen518052China[Abstract]Objective:ToinvestigatetheclinicaldistributionandantimicrobialresistancemechanismofImipenem-resistantpseudomonasaeruginosa(IRPA).Methods:Dataonnon-recurrentIRPAisolatedfrominpatientsofthishospitalfromJanaury2009toDecember2010werestatisticallyanalyzed.β-lactamasegeneandtheoutermembranechannelproteingeneweredeterminatedbyusingPCRmethod.Results:404strainsofP.aeruginosa100strainswereresistanttoImipenemindicatingthatIRPAwasisolatedatarateof24.75%.Ofthesestrains90strains(90.0%)wereprimarilyisolatedfromsputum.IRPAoriginatedprimarilyinICU.ThelowestdrugresistancewastoAmikacin(27.0%)followedbyPiperacillin/Tazobactam(63.0%)Piperacillin(59.0%)Gentamicin(58.0%)Ceftazidime(57.0%)theratesofdrugresistancetotheotherantibioticswerelessthan50.0%.OnlyonestrainofIRPAwasdetectedpositivebyIMPgene(1.0%)andsequencingresultshoweditwasaIMP-9typemetallo-β-lactamases(MBL)genewhileotherMBLgeneswerenotdetected.TheabsentrateofoprD2genewas65.0%.Conclusion:ThelossofoprD2