75株碳青霉烯类耐药铜绿假单胞菌ERIC-PCR菌种分型及其主要耐药机制研究

doi:10.3969/j.issn.1673-8640.2014.07.015

检验医学 ›› 2014, Vol. 29 ›› Issue (7): 755-759.DOI: 10.3969/j.issn.1673-8640.2014.07.015

75株碳青霉烯类耐药铜绿假单胞菌ERIC-PCR菌种分型及其主要耐药机制研究

张勇¹，刘爱胜²，文艳³

1.深圳市龙华新区观澜人民医院检验科，广东深圳 518110；
2.深圳市龙华新区人民医院检验科，广东深圳 518109；
3.深圳市光明新区人民医院ICU，广东深圳 518106

收稿日期:2014-01-23 出版日期:2014-07-30 发布日期:2014-07-21
通讯作者: 刘爱胜，联系电话:0755-28015351。
作者简介:张勇，男，1972年生，学士，主管技师，主要从事微生物及临床检验工作。

ERIC-PCR typing and main drug resistance mechanism in 75 isolates of carbapenem-resistant Pseudomonas aeruginosa

ZHANG Yong¹,LIU Aisheng²,WEN Yan³

1.Department of Clinical Laboratory, Guanlan People′s Hospital of Shenzhen Longhua New District, Guangdong Shenzhen 518110, China;
2. Department of Clinical Laboratory, Shenzhen Longhua New District People′s Hospital, Guangdong Shenzhen 518109, China;
3.ICU, Shenzhen Guangming New District People′s Hospital, Guangdong Shenzhen 518106, China

Received:2014-01-23 Online:2014-07-30 Published:2014-07-21

摘要/Abstract

摘要：

目的　探讨碳青霉烯类耐药的铜绿假单胞菌同源性及其主要耐药机制。方法　收集临床标本946份，分离出碳青霉烯类耐药的铜绿假单胞菌，采用琼脂稀释法进行体外药物敏感性试验；采用肠杆菌基因间重复一致序列为引物的聚合酶链反应（ERIC-PCR）进行耐药菌株同源性分析；筛选其金属β-内酰胺酶并测定主动外排系统表型来分析碳青霉烯类耐药的铜绿假单胞菌的耐药性。结果　共检测出75株碳青霉烯类耐药的铜绿假单胞菌； ERIC-PCR同源性分析显示75株菌株共分为8个型别，其中A型占34.7%（26株）、B型占22.7%（17株）；75株碳青霉烯类耐药的铜绿假单胞菌中有13株为产酶株，产酶率为17.3%；外排泵抑制剂MC207110可以使34株美罗培南耐药株的最低抑菌浓度（MIC）较单药时下降4倍或以上，占63.0%。结论　本院分离的耐碳青霉烯类铜绿假单胞菌主要有两种类型，产生碳青霉烯水解酶和外排泵机制是碳青霉烯类耐药铜绿假单胞菌耐药的重要机制。

关键词: 铜绿假单胞菌, 碳青霉烯类耐药, 肠杆菌基因间重复一致序列为引物的聚合酶链反应, β-内酰胺酶, 主动外排

Abstract:

Objective To investigate the homology and main drug resistance mechanism of carbapenem-resistant Pseudomonas aeruginosa. Methods　A total of 946 samples were collected， and carbapenem-resistant Pseudomonas aeruginosa were isolated. The drug sensitivity of carbapenem-resistant Pseudomonas aeruginosa were detected by agar dilution test. Enterobacterial repetitive intergenic consensus-polymerase chain reaction（ERIC-PCR） was performed to analyze homology. The isolates were screened by metallo-beta-lactamae. The efflux pump of Pseudomonas aeruginosa resistant to carbapenem antibiotics was detected by efflux pump inhibitor test. Results　A total of 75 isolates of carbapenem-resistant Pseudomonas aeruginosa were isolated. The ERIC-PCR homology analysis showed 8 types， in which A-type and B-type were the main types， accounting for 34.7%（26 isolates） and 22.7%（17 isolates）， respectively. In the 75 isolates resistant to carbapenems， 13 isolates were positive in metal enzyme test， accounting for 17.3%. MC207110 efflux pump inhibitor could make the minimal inhibitory concentration（MIC） of meropenem in 34 isolates being resistant to meropenem decreasing by 4 times or more， compared with single drug therapy， accounting for 63.0%. Conclusions　There are mainly 2 kinds of cloning existing in Pseudomonas aeruginosa being resistant to carbapenem. The production of metallo-beta-lactamase and multi-drug resistant efflux system play important roles in the drug resistance of Pseudomonas aeruginosa.

Key words: Pseudomonas aeruginosa, Carbapenem-resistance, Enterobacterial repetitive intergenic consensus-polymerase chain reaction, Beta-lactamase, Efflux pump

中图分类号:

R446.5

张勇，刘爱胜，文艳. 75株碳青霉烯类耐药铜绿假单胞菌ERIC-PCR菌种分型及其主要耐药机制研究[J]. 检验医学, 2014, 29(7): 755-759.

ZHANG Yong,LIU Aisheng,WEN Yan. ERIC-PCR typing and main drug resistance mechanism in 75 isolates of carbapenem-resistant Pseudomonas aeruginosa[J]. , 2014, 29(7): 755-759.

参考文献

[1] 范倩燕,沈敏,汤园园,等.医院感染的病原菌特点及耐药性分析[J].检验医学,2012,27(5):396-399.
[2] 赵津彩,张跃栋.520株铜绿假单胞菌临床分布和耐药性分析[J].检验医学,2013,28(8):734-736.
[3] 袁红萍,周文俊,高卫亚,等.重症监护病房鲍曼不动杆菌及铜绿假单胞菌的耐药性监测[J].检验医学,2014,29(1):91-92.
[4] National Committee for Clinieal Laboratory Standards. Peformance standards for antimicorbial susceptibility testing[S]. M100-512,NCCLS,2002.
[5] Tenover FC,Arbeit RD,Goering RV, et al. Interpreting chromosomal DNA restrietion patterns produeed by pulsed-field gel elestrophoresis: criteria for baeterial strain typing[J]. J Clin Microbiol,1995,33(9): 2233-2239.
[6] 谢薇,刘原,张毅.西安地区耐亚胺培南铜绿假单胞菌中金属β-内酰胺酶的检测[J].四川大学学报(医学版), 2008, 39(5): 856-857.
[7] 李继霞,公衍文.多重耐药菌医院感染状况分析[J].检验医学,2013,28(9):784-788.
[8] 何力志,黄露萍,李志芳,等.耐亚胺培南铜绿假单胞菌金属β-内酰胺酶的检测及耐药性分析[J].检验医学,2013,28(5):353-356.
[9] 严育忠,范惠清,郑文龙,等.改良亚胺培南-EDTA纸片增效试验检测铜绿假单胞菌产金属酶表型[J].检验医学,2014,29(1):65-68.
[10] Versalovic J, Koeuth T, Lupski JR. Distribution of repetitive DNA sequences in eubacteria and application to fingerprinting of bacterial genomes[J]. Nucleic Acids Res, 1991,19(24): 6823-6831.
[11] Di Giovanni GD, Watrud LS, Seidler RJ, et al. Fingerprinting of mixed bacterial strains and BIOLOG gram-negative (GN) substrate communities by enterobacterial repetitive intergenic consensus sequence-PCR (ERIC-PCR)[J]. Curr Microbiol, 1999,38(4): 217-223.
[12] Syrmis MW,O′Carroll MR,Sloots TP,et al. Rapid genotyping of Pseudomonas aeruginosa isolates harboured by adult and paediatric patients with cystic fibrosis using repetitive-element-based PCR assays[J]. J Med Microbiol, 2004,53(Pt11):1089-1096.
[13] Ozgumus OB,Caylan R,Tosun I,et al. Molecular epidemiology of clinical Pseudomonas aeruginosa isolates carrying IMP-1 metallo-beta-lactamase gene in a University Hospital in Turkey[J]. Microb Drug Resist, 2007, 13(3): 191-198.
[14] Eikermann M, Hunkemller I, Peine L, et al. Optimal rocuronium dose for intubation during inhalation induction with sevoflurane in children[J]. Br J Anaesth, 2002, 89(2): 277-281.
[15] El-Orbany MI, Joseph NJ, Salem MR,et al. The neuromuscular effects and tracheal intubation conditions after small doses of succinylcholine[J]. Anesth Analg, 2004, 98(6): 1680-1685.

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75株碳青霉烯类耐药铜绿假单胞菌ERIC-PCR菌种分型及其主要耐药机制研究

ERIC-PCR typing and main drug resistance mechanism in 75 isolates of carbapenem-resistant Pseudomonas aeruginosa

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