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目的调查215株湖州地区临床分离铜绿假单胞菌对氨基糖苷类抗生素的耐药性和16S rRNA甲基化酶基因分布情况。方法收集2011年1月至2012年12月湖州地区临床分离铜绿假单胞菌215株,琼脂稀释法测定5种氨基糖苷类抗菌药物(庆大霉素、阿米卡星、妥布霉素、伊帕米星、奈替米星)的MIC值;PCR检测armA、rmtA、rmtB、rmtC、rmtD和npmA六种氨基糖苷类16S rRN甲基化酶基因,序列分析明确基因型。测定产16S rRNA甲基化酶菌株对常见抗菌的敏感性,并检测碳青霉烯耐药株产碳青霉烯酶情况。结果铜绿假单胞菌对异帕米星敏感率最高为81.4%,对5种氨基糖苷类抗生素全部耐药的22株菌株中,17株检出armA基因;未发现其他16S rRNA甲基化酶基因阳性菌株。17株armA阳性菌株对碳青霉烯类抗生素耐药5株(耐药率为29.4%),对头孢他啶、头孢吡肟、哌拉西林/他唑巴坦、环丙沙星耐药率均超过40%。5株碳青霉烯耐药菌株中检测到2株产VIM-2型金属碳青霉烯酶。结论铜绿假单胞菌对氨基糖苷类抗生素耐药率高,检测到16S rRNA甲基化酶基因armA。产16S rRNA甲基化酶铜绿假单胞菌耐药性强,部分菌株同时产金属碳青霉烯酶,给临床抗感染治疗及院内感染控制带来挑战。
Objective To investigate the resistance to aminoglycoside antibiotics and the distribution of 16S rRNA methylase genes in 215 clinical isolated Pseudomonas aeruginosa strains in Huzhou area. Methods 215 clinical isolates of Pseudomonas aeruginosa in Huzhou area from January 2011 to December 2012 were collected. Five kinds of aminoglycoside antibiotics (gentamycin, amikacin, tobramycin, Ipamycins, netilmicin). Sixteen aminoglycoside 16S rRN methylase genes were detected by PCR, including armA, rmtA, rmtB, rmtC, rmtD and npmA. The genotypes were determined by sequence analysis. Determination of 16S rRNA methylase strains susceptible to common antibiotics, and carbapenem-resistant carbapenem-producing strains detected. Results The sensitivity of Pseudomonas aeruginosa to iso-pamirin was the highest (81.4%). Out of the 22 isolates resistant to all 5 aminoglycoside antibiotics, 17 strains detected armA gene. No other 16S rRNA methylase Gene-positive strains. 17 strains of armA-positive strains were resistant to carbapenem-resistant strains (resistance rate was 29.4%), the resistance rates to ceftazidime, cefepime, piperacillin / tazobactam and ciprofloxacin all exceeded 40%. Five strains of carbapenem-resistant strains detected two strains producing VIM-2 carbapenem. Conclusions Pseudomonas aeruginosa has high resistance to aminoglycoside antibiotics, and 16S rRNA methylase gene armA was detected. Producing 16S rRNA methylase Pseudomonas aeruginosa drug-resistant, some strains at the same time produce carbapenemase, to clinical anti-infective treatment and nosocomial infection control challenges.