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目的研究耐亚胺培南铜绿假单胞菌对常用抗菌药物耐药性及其产碳青霉烯酶的基因特征。方法对耐亚胺培南铜绿假单胞菌的耐药性进行回顾性分析;Carba NP法进行碳青霉烯酶表型确证;PCR进行基因型检测。结果 640株耐亚胺培南铜绿假单胞菌对氨曲南耐药率最高,为58.8%;对3种氨基糖苷类耐药率最低,为19.2%~20.6%;对其他6种抗菌药物耐药率为40.0%~51.1%。检出72株耐亚胺培南铜绿假单胞菌产碳青霉烯酶,阳性率为11.3%。基因型检测3株为KPC-2型,占4.2%,26株为IMP型,占36.1%,43株为VIM型,占59.7%。结论耐亚胺培南铜绿假单胞菌对氨基糖苷类敏感性较好,但对其他抗菌药物耐药性严重;碳青霉烯酶主要以金属β-内酰胺酶为主。
Objective To study the resistance of imipenem-resistant Pseudomonas aeruginosa to commonly used antibacterials and the gene characterization of carbapenemase. Methods The resistance to imipenem-resistant Pseudomonas aeruginosa was retrospectively analyzed. Carba NP method was used to confirm the carbapenemase phenotype. PCR was used to detect the genotype. Results 640 strains of imipenem-resistant Pseudomonas aeruginosa showed the highest resistance rates to aztreonam (58.8%), the lowest rates of resistance to three aminoglycosides (19.2% -20.6%), the other 6 antibiotics Resistance rate was 40.0% ~ 51.1%. 72 strains of imipenem-resistant Pseudomonas aeruginosa produced carbapenemase, the positive rate was 11.3%. Three genotypes were KPC-2, accounting for 4.2%, 26 were IMP, accounting for 36.1% and 43 were VIM, accounting for 59.7%. Conclusion The resistance of imipenem-resistant Pseudomonas aeruginosa to aminoglycosides is good, but it is resistant to other antibacterials. Carbapenemase is predominantly metal β-lactamase.