目的 探讨分离自下呼吸道感染患者的氨基糖苷类耐药铜绿假单胞菌的耐药机制.方法 从下呼吸道感染患者痰液中分离出52株对氨基糖苷类耐药的铜绿假单胞菌,PCR法检测6种氨基糖苷类修饰酶(AMEs)基因,并检测其中泛耐药菌的6种16S rRNA甲基化酶基因(以下简称甲基化酶基因).对阳性产物测序加以证实.结果 52株铜绿假单胞菌中检出4种AMEs基因[aac(3)-Ⅱ、aac(6')-Ⅰ b、aac(6’)-Ⅱ和ant(2")-Ⅰ],AMEs基因总检出率为92.3％.泛耐药菌中检出1种甲基化酶基因(rmtB).16株高水平泛耐药菌中rmtB基因的检出率为81.3％.结论 分离自下呼吸道感染患者的氨基糖苷类耐药铜绿假单胞菌中AMEs基因携带率高,其对氨基糖苷类耐药与aac(3)-Ⅱ、aac(6’)-Ⅰb、aac(6')-Ⅱ和ant(2")-Ⅰ有关；对氨基糖苷类高水平泛耐药主要与甲基化酶基因rmtB有关.%Objective To explore the resistant mechanism to aminoglycosides among Pseudomonas aeruginosa ( PAE) strains isolated from patients with lower respiratory tract infection. Methods Total of 52 aminoglycosides-resistant PAE strains were isolated from sputum of patients with lower respiratory tract infection, 6 kinds of aminoglycosides modification enzymes ( AMEs) genes among all the isolates and 6 kinds of 16S rRNA methylase genes among the isolates that pan-resist-ant to aminoglycosides sequenced. Results Among 52 isolates of PAE, 4 kinds of AMEs genes [aac(3)-Ⅱ , aac(6')- Ⅰ b, aac(6')-Ⅱ andant(2")-I ] were found. The total positive rates of AMEs genes was 92. 3% . Among the isolates that pan-resistant to aminoglycosides, 1 kind of 16S rRNA methylase gene (rmtB) was found. The positive rate of rmtB in 16 i-solates that high level pan-resistant to aminoglycosides was 81.3%. Conclusion The positive rate of AMEs genes is very high among aminoglycosides-resistant PAE strains isolated from patients with lower respiratory tract infection. The AMEs genes related to aminoglycosides resistance include aac(3)-Ⅱ , aac(6')- Ⅰ b, aac(6')-Ⅱ and ant(2")- Ⅰ . The high level pan-resistance to aminoglycosides is mainly related to 16S rRNA methylase gene rmtB.
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