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目的了解2011-2012年深圳市南山区医院患者,各医院诊所内环境、医护人员手涂抹样以及食品样中铜绿假单胞菌(Pseudomonas aeruinosa,PA)对抗生素耐药性及携带耐药基因情况。方法利用VITEK 2 compact全自动微生物鉴定仪对PA菌进行药敏试验。采用聚合酶链反应(polymeras chain reaction,PCR)技术检测PA的20种耐药基因:β-内酰胺TEM、VEB、CARB、OXA、SHV、PER、GES、GTX、SPM、GIM,金属β-内酰胺酶IMP、VIM,AmpC酶DHA,膜通道蛋白oprD,氨基糖苷类修饰酶Aac(6’)-Ⅰ、Aac(6’)-Ⅱ、Aac(3’)-Ⅰ、Aac(2’)-Ⅰ,耐消毒基因qacE1-sull与Ⅰ类整合子基因。结果药敏试验显示53株菌对11种抗菌药物阿米卡星、氨苄西林等耐药率为100%,对呋喃妥因、亚胺培南等耐药率为10%~30%。检出11种耐药基因:TEM、SHV、IMP、DHA、Aac(6’)-Ⅰ、Aac(6’)-Ⅱ、Aac(3’)-Ⅰ、Aac(2’’)-Ⅰ、qacE1-sull、Ⅰ类整合子及oprD基因,检出率分别为7.54%、5.66%、3.77%、11.32%、5.66%、15.09%、5.66%、58.49%、9.43%和9.43%,oprD基因缺失率为67.93%。结论部分分离自患者菌株呈多重耐药,且携带多种耐药基因,应引起高度重视。不同类型样本分离菌株携带耐药基因存在差异。
Objective To understand the antibiotic resistance and drug-resistant gene of Pseudomonas aeruinosa (PA) in patients in Nanshan District Hospital of Shenzhen City, hospitals in clinics, hand smears of medical staff and food in 2011-2012 . Methods The susceptibility test of PA was carried out by using VITEK 2 compact automatic microbial identification instrument. Polymerase chain reaction (PCR) was used to detect 20 drug resistance genes of PA: β-lactam TEM, VEB, CARB, OXA, SHV, PER, GES, GTX, SPM, GIM, AAC (6 ’) - Ⅰ, Aac (6’) - Ⅱ, Aac (3 ’) - Ⅰ, Aac (2’) - Ⅰ, qacE1-sull, a disinfectant gene and class Ⅰ integron gene. Results The results of drug susceptibility test showed that 53 isolates were resistant to 11 antibacterial drugs amikacin and ampicillin, with resistance rate of 10% -30% to nitrofurantoin and imipenem. A total of 11 resistance genes were detected including TEM, SHV, IMP, DHA, Aac (6 ’) - Ⅰ, Aac (6’) - Ⅱ, Aac (3 ’) - Ⅰ, Aac (2 " The positive rate of oprD gene deletion was 7.54%, 5.66%, 3.77%, 11.32%, 5.66%, 15.09%, 5.66%, 58.49%, 9.43% and 9.43% 67.93%. Conclusion Some strains isolated from patients were multi-drug resistant, and carry a variety of drug resistance genes, should be highly valued. Different types of strains isolated strains carrying resistance genes are different.