CAJ | 학술논문

目的：探讨铜绿假单胞菌金属酶β‐内酰胺酶和外膜蛋白OprD2表达与碳青霉烯类抗生素耐药之间的关系。方法采用微量肉汤稀释法测定多利培南、美罗培南、亚胺培南对铜绿假单胞菌的最低抑菌浓度；应用亚胺培南‐乙二胺四乙酸（EDTA）双纸片增效法对耐碳青霉烯菌株进行金属酶表型检测；采用聚合酶链反应（PCR）检测耐碳青霉烯菌株的blaIMP和blaVIM 型金属酶基因和外膜孔道蛋白OprD2基因表达。结果应用亚胺培南‐EDTA双纸片增效试验检测30株耐碳青霉烯铜绿假单胞菌金属酶表型，结果均为阴性，PCR未扩增出 blaIM P、blaVIM 型基因。25株耐碳青霉烯铜绿假单胞菌O prD2基因表达缺失。25株表达缺失菌株全部对亚胺培南耐药，仍有7株对美罗培南、13株对多利培南敏感。结论产金属酶不是我院铜绿假单胞菌对碳青霉烯类抗生素耐药的主要机制，外膜蛋白OprD2表达缺失是铜绿假单胞菌对亚胺培南耐药的主要机制，对美罗培南和多利培南的耐药还需要其他机制共同作用。
목적：탐토동록가단포균금속매β‐내선알매화외막단백OprD2표체여탄청매희류항생소내약지간적관계。방법채용미량육탕희석법측정다리배남、미라배남、아알배남대동록가단포균적최저억균농도；응용아알배남‐을이알사을산（EDTA）쌍지편증효법대내탄청매희균주진행금속매표형검측；채용취합매련반응（PCR）검측내탄청매희균주적blaIMP화blaVIM 형금속매기인화외막공도단백OprD2기인표체。결과응용아알배남‐EDTA쌍지편증효시험검측30주내탄청매희동록가단포균금속매표형，결과균위음성，PCR미확증출 blaIM P、blaVIM 형기인。25주내탄청매희동록가단포균O prD2기인표체결실。25주표체결실균주전부대아알배남내약，잉유7주대미라배남、13주대다리배남민감。결론산금속매불시아원동록가단포균대탄청매희류항생소내약적주요궤제，외막단백OprD2표체결실시동록가단포균대아알배남내약적주요궤제，대미라배남화다리배남적내약환수요기타궤제공동작용。
Objective To study the relation between metallo‐β‐lactamase and outer membrane protein OprD2 with carbapenem‐resistance in pseudomonas aeruginosa .Methods MIC of doripenem , meropenem ,imipenem against pseudomonas aeruginosa were determined by broth dilution method . Metallo‐β‐enzymes phenotypic screening of the carbapenem‐resistant strains was examined by IMP‐EDTA combined disk test .Polymerase chain reaction (PCR) confirmed the blaVIM ,blaIMP and OprD2 gene . Results The results of IMP‐EDTA combined disk test showed that no strains was positive .There were no blaIM P and blaVIM‐type MBLs detected in the 30 carbapenem‐resistant pseudomonas aeruginosa by PCR .25 carbapenem‐resistant PA were determined as lack of OprD2 gene .All of the 25 PA loss of OprD2 were resistant to imipenem ,but 7 PA loss of OprD2 were sensitive to meropenem and 13 were sensitive to doripenem .Conclusions MBLs were not the main mechanism of carbapenem resistance for pseudomonas aeruginosa in our hospital .Loss of OprD2 was the main mechanism of imipenem‐resistant pseudomonas aeruginosa ,but there were other mechanisms in doripenem , meropenem‐resistant pseudomonas aeruginosa .