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目的研究多药耐药铜绿假单胞菌的外排泵及其暴发流行情况,为临床应用抗菌药物治疗和控制医院感染暴发提供参考依据。方法收集宁夏医科大学总医院2011年9月-2013年9月住院患者的各种临床标本中分离的785株铜绿假单胞菌,采用K-B法测定铜绿假单胞菌对抗菌药物的耐药性,用聚合酶链反应(PCR)检测其外排泵基因并用琼脂糖凝胶电泳对多药耐药菌株进行同源性分析,数据采用WHONET 5.6软件进行统计分析。结果铜绿假单胞菌对多数抗菌药物耐药,且耐药率呈逐年上升趋势;在124株多药耐药铜绿假单胞菌中74株MexAB-OprM外排泵表型阳性;脉冲场凝胶电泳分为75个基因型,同一型的几乎来自同一科室,主要分布在ICU和呼吸科。结论医院分离的多药耐药铜绿假单胞菌外排泵以MexAB-OprM最多,其广泛存在是铜绿假单胞菌产生多药耐药的主要机制之一;分型主要有5个基因型,其他均为散发菌株,并无暴发流行趋势。
Objective To study the efflux pumps and their outbreaks of multidrug-resistant Pseudomonas aeruginosa, and to provide a reference for clinical application of antimicrobial drugs and control of nosocomial infections. Methods A total of 785 strains of Pseudomonas aeruginosa isolated from various clinical specimens of hospitalized patients of Ningxia Medical University General Hospital from September 2011 to September 2013 were collected and the drug resistance of Pseudomonas aeruginosa to antibiotics was determined by KB method The gene of efflux pump was detected by polymerase chain reaction (PCR) and the homology analysis of multidrug resistant strains was carried out by agarose gel electrophoresis. The data were analyzed by WHONET 5.6 software. Results Pseudomonas aeruginosa was resistant to most antibiotics, and the drug resistance rate showed an upward trend year by year. Among the 124 multidrug-resistant Pseudomonas aeruginosa, 74 strains of MexAB-OprM efflux pump were positive, Gel electrophoresis is divided into 75 genotypes, the same type almost from the same department, mainly in the ICU and respiratory department. Conclusion The majority of MexAB-OprM efflux pumps in multidrug-resistant Pseudomonas aeruginosa isolated in hospital are the most common mechanism of multidrug resistance in Pseudomonas aeruginosa. There are 5 genotypes , Others were distributed strains, there is no outbreak trend.