黏液型铜绿假单胞菌的毒力基因、产金属酶检测与耐药性研究

摘要

Objective To comparison in virulence genes,metallo-β-lactanase-producing(MBLs)and drug-resistance between mucoid and non-mucoid Pseudomonas aeruginosa(PAE),and provide reference for the clinical use of antimicro-bial agents.Methods All strains were identified by ATB strip,drug-resistance by K-B method,virulence genes exoS、exoU and exoY by PCR,and MBLs by modified Hodge Test(MHT).Results Of 13 kinds of antimicrobial agents,Non-mucoid PAE were higher resistance than mucoid PAE,and were significantly higher than mucoid PAE in gentamicin, aztreonam,levofloxacin,imipenem and meropenem.The detection rates of MBLs,exoU+/exoS-/exoY-and exoU-/ex-oS-/exoY-of 6 kinds genotyopes in non-mucoid PAE were significantly higher than mucoid PAE.The detection rates of 3 kinds of virulence genes in mucoid PAE were higher than non-mucoid PAE,but they were not significant.Conclusion For avoiding non-mucoid turn into mucoid,we must select the sensitive antibiotic early and quikly to remedy PAE in-fection.%目的 比较两种表型铜绿假单胞菌(PAE)毒力基因、产金属酶(MBLs)及耐药性,为临床治疗和医院感染控制提供依据.方法 采用ATB鉴定系统进行菌株鉴定,筛选出两种表型菌株;纸片扩散法检测耐药性;PCR方法检测毒力基因exoS、exoU和exoY;改良Hodge试验(PAE-MHT)法检测MBLs.结果 非黏液型PAE对各种抗生素的耐药率均高于黏液型,其中对庆大霉素、氨曲南、左氧氟沙星、亚胺培南、美罗培南的耐药率明显高于黏液型;同时非黏液型MBLs阳性率明显高于黏液型;3种毒力基因阳性率黏液型均高于非黏液型,但两者比较无显著性差异;6种基因型中,除exoU+/exoS-/exoY-和exoU-/exoS-/exoY-两种基因型非黏液型明显高于黏液型外,其余四种基因型的比较无显著性差异.结论 针对PAE感染,应尽早尽快选择敏感药物治疗,以免非黏液型转化成黏液型后,增加治疗难度.