昆明地区铜绿假单胞菌ESBLs基因型和耐药性研究
Investigation of Resistance and Genotypes of Extended-spectrum β-lactamases Produced by Pseudomonas aeruginosa in Kunming
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摘要: [摘要]目的 了解昆明地区临床分离的铜绿假单胞菌中超广谱β-内酰胺酶(ESBLs)基因的分布情况及耐药性特点.方法 收集昆明地区4家医院临床标本中分离的铜绿假单胞菌125株,用VITEK32型全自动细菌鉴定仪进行细菌鉴定,用纸片扩散法检测其对20种抗菌药物的耐药性,用聚合酶链反应法对其进行基因检测,靶基因为TEM、SHV、OXA、PER、VEB、GES、CTX-M-1共7种ESBLs基因,对检测的阳性产物进行测序,并对照GenBank确定基因类型.结果 125株PA对多种β-内酰胺类抗菌药物有较高耐药率,对氨基糖苷类抗菌药物的耐药率较低.昆明地区4家医院PA中ESBLs基因检出率均在90%以上,7种主要的ESBLs基因型(PER、VEB、GES、TEM、SHV、OXA、CTX-M)均有检出,其中TEM型检出率占76%.结论 昆明地区PA中ESBLs基因检出率高,基因型分布较广,TEM是其中流行的主要基因型,各医院应规范临床用药,并加强联合动态监测.
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关键词:
- [关键词]铜绿假单胞菌 /
- 超广谱β-内酰胺酶 /
- 耐药基因
Abstract: [Abstract]Objective To investigate the drug resistance of clinical isolated Pseudomonas aeruginosa(PA) and the genotypes of extended-spectrum β-lactamases(ESBLs)produced by them in Kunming. Methods 125 clinical isolates of PA were collected from 4 hospitals in Kunming and identified with VITEK-32 automated bacteria identification instrument. The Kirby-Bauer method was used for antimicrobial susceptibility to 20 kinds of antibiotics. And polymerase chain reaction(PCR)analysis was used to detect 7 kinds of ESBLs genes including TEM,SHV, OXA,PER,VEB,GES and CTX-M-1. DNA sequencing was used to detect the positive production of PCR with GenBank as control. Results The resistance rates of 125 isolated PA were high to beta-lactam antibiotics,but low to aminoglycosides antibiotics. The detection rates of ESBLs genes were all above 90% from 4 hospitals in Kunming, and 7 kinds of ESBLs genes were all detected. Among the 7 kinds of ESBLs genes,the detection rate of TEM was 76%. Conclusion The detection rates of ESBLs genes were high in Kunming,and the distribution of ESBLs genotypes was varied. TEM was a main genotype among prevalent ESBLs genotypes. For local hospitals, attention must be paid to reasonable use of antibiotics,and should strengthen laboratories associated surveillance dynamically.
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