CAJ | 학술논문

目的研究烟台地区产金属β-内酰胺酶铜绿假单胞菌的耐药性,基因型及菌株的同源性,为监控产酶菌株的流行及指导临床合理选择抗生素提供依据.方法 EDTA纸片复合法和E-test法分别筛选产金属β-内酰胺酶菌株,PCR扩增耐药基因imp、vim、spm和gim,用MIC法测定产金属β-内酰胺酶菌株对8种常用抗菌药物的敏感度,用肠杆菌科基因间重复一致序列为引物的聚合酶链反应(ERIC-PCR方法 )确定菌株之间的同源性.结果 42株耐亚胺培南和头胞他啶铜绿假单胞菌EDTA纸片复合法筛选出18株金属酶菌株、E-test法15株、PCR法12株;PCR法检测到imp阳性菌株4株,vim阳性菌株8株;产金属β-内酰胺酶菌株呈多重耐药,且PCR法阳性产金属酶菌株呈现为高水平耐药;ERIC-PCR结果显示,18株产金属β-内酰胺酶菌株呈现7种基因模型,其中10株为同一基因模型.结论经济简便快捷的EDTA纸片复合法可作为首选方法来对产金属酶铜绿假单胞菌进行筛选,烟台地区临床分离的铜绿假单胞菌所产金属β-内酰胺酶基因型以vim型为主,阿米卡星、环丙沙星具有较好的抗菌活性,某医院在一定时期曾出现爆发流行.
목적 연구연태지구산금속β-내선알매동록가단포균적내약성,기인형급균주적동원성,위감공산매균주적류행급지도림상합리선택항생소제공의거.방법 EDTA지편복합법화E-test법분별사선산금속β-내선알매균주,PCR확증내약기인imp、vim、spm화gim,용MIC법측정산금속β-내선알매균주대8충상용항균약물적민감도,용장간균과기인간중복일치서렬위인물적취합매련반응(ERIC-PCR방법 )학정균주지간적동원성.결과 42주내아알배남화두포타정동록가단포균EDTA지편복합법사선출18주금속매균주、E-test법15주、PCR법12주;PCR법검측도imp양성균주4주,vim양성균주8주;산금속β-내선알매균주정다중내약,차PCR법양성산금속매균주정현위고수평내약;ERIC-PCR결과 현시,18주산금속β-내선알매균주정현7충기인모형,기중10주위동일기인모형.결론 경제간편쾌첩적EDTA지편복합법가작위수선방법 래대산금속매동록가단포균진행사선,연태지구림상분리적동록가단포균소산금속β-내선알매기인형이vim형위주,아미잡성、배병사성구유교호적항균활성,모의원재일정시기증출현폭발류행.
Objective To study the genotypes, antimicrobial resistance and the homology of metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa isolated from clinical specimens in Yantai area, so as to provide basis for reasonable selection of antibiotics and monitoring of the prevalence of metallo-beta-lactamase-producing strains. Methods Metallo-β-lactamase positive strains were screened from imipenem-resistant and ceftazidime-resistant pseudomonas aeruginosa isolates by E-test strips method and EDTA-IMP disk diffusion method; PCR was performed to amplify the resistant genes of imp, vim, spm and gim. Microdilution test were used to determine the MICs of 8 antibiotics;the homology among different strains was tested by enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR) method. Results Among 42 strains, there were 18 strains screened with EDTA-IMP disk diffusion method, 15 strains with E-test, 12 strains with PCR, including 4 strains with specific bands of imp and 8 strains with vim bands. The metallo-β-lactamase-producing strains were multidrug resistant, and the PCR positive strains were highly resistant. Results of ERIC-PCR genotyping showed that there were seven PCR patterns among 18 strains screened by EDTA-IMP disk diffusion method, and 10 strains were in the same pattern. Conclusion EDTA-IMP disk diffusion method may be the first choice to screen MBL producing strains in Pseudomonas aeruginosa because of its economy, convenience and quickness. The major MBL genetype of Pseudomonas aeruginosa isolates is vim in Yantai area; the isolates are sensitive to amikacin and ciprofloxacin. The MBL producing strains in Pseudomonas aeruginosa appeared an outbreak in a certain hospital.