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  本文關(guān)鍵詞：銅綠假單胞菌耐藥性及其產(chǎn)超廣譜β-內(nèi)酰胺酶實(shí)驗(yàn)研究　出處：《安徽理工大學(xué)》2007年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 銅綠假單胞菌 耐藥性 超廣譜β-內(nèi)酰胺酶 PCR

【摘要】： 目的調(diào)查醫(yī)院內(nèi)感染銅綠假單胞菌的耐藥現(xiàn)狀,并確定耐藥菌株產(chǎn)超廣譜β-內(nèi)酰胺酶種類(lèi)。 方法采集臨床標(biāo)本,常規(guī)分離培養(yǎng),采用Phoenix-100系統(tǒng)進(jìn)行菌種鑒定,根據(jù)NCCIS標(biāo)準(zhǔn)通過(guò)紙片瓊脂擴(kuò)散法進(jìn)行藥敏試驗(yàn);疑似產(chǎn)超廣譜β-內(nèi)酰胺酶細(xì)菌采用紙片擴(kuò)散法ESBLs檢測(cè)試驗(yàn)初步確證銅綠假單胞菌產(chǎn)超廣譜β-內(nèi)酰胺酶,提取細(xì)菌質(zhì)粒DNA和染色體DNA,PCR試驗(yàn)檢測(cè)ESBLs基因種類(lèi)。 結(jié)果臨床標(biāo)本分離到64株銅綠假單胞菌,64株銅綠假單胞菌對(duì)臨床常用抗生素藥敏試驗(yàn)結(jié)果顯示對(duì)青霉素類(lèi)、第一、二代頭孢菌素類(lèi)抗生素、頭霉素類(lèi)抗生素頭孢西丁及復(fù)方磺胺的耐藥率均較高,達(dá)90%以上,對(duì)第三代頭孢菌素耐藥率在20%—50%之間;對(duì)碳青酶烯類(lèi)抗生素亞胺培南耐藥率為15.6%;對(duì)酶抑制劑復(fù)合制劑替卡西林/克拉維酸耐藥率為20.3%;對(duì)氨基糖苷類(lèi)抗生素阿米卡星及喹諾酮類(lèi)抗生素環(huán)丙沙星的耐藥率分別為32.8%和29.7%。紙片擴(kuò)散法ESBLs檢測(cè)試驗(yàn)確證有27株銅綠假單胞菌產(chǎn)超廣譜β-內(nèi)酰胺酶,比較產(chǎn)ESBLs和非產(chǎn)ESBLs菌株耐藥性,產(chǎn)ESBLs菌株對(duì)哌拉西林、頭孢哌酮、頭孢曲松、頭孢他啶及氨曲南的耐藥率明顯高于非產(chǎn)ESBLs菌株(P＜0.05)。PCR試驗(yàn)檢測(cè)ESBLs基因類(lèi)型,20株銅綠假單胞菌質(zhì)粒DNA和染色體DNA中均有TEM型基因;有4株銅綠假單胞菌質(zhì)粒DNA中檢測(cè)到OXA-10型基因,有2株細(xì)菌染色體DNA存在OXA-10型基因;其中有1株細(xì)菌的質(zhì)粒DNA中同時(shí)檢測(cè)到了TEM型基因和OXA-10型基因。 結(jié)論本院醫(yī)院內(nèi)感染銅綠假單胞菌對(duì)臨床常用抗生素耐藥性和全國(guó)其他地區(qū)有差別:本院醫(yī)院內(nèi)感染銅綠假單胞菌產(chǎn)ESBLs率較高,檢測(cè)了TEM型酶和OXA-10型酶,以TEM型酶較多;銅綠假單胞菌編碼ESBLs基因多位于質(zhì)粒DNA上,同時(shí)也存在于染色體DNA上;銅綠假單胞菌耐藥性復(fù)雜多樣,對(duì)第三代頭孢菌素抗生素耐藥機(jī)制主要以產(chǎn)ESBLs為主。 圖[11]表[7]參[54]
[Abstract]:Objective to investigate the drug resistance of Pseudomonas aeruginosa in hospital and to identify the extended-spectrum 尾 -lactamases. Methods Clinical specimens were collected, isolated and cultured routinely, strain identification was carried out by Phoenix-100 system, and drug sensitivity test was carried out by paper Agar diffusion method according to NCCIS standard. Extended-spectrum 尾 -lactamase producing bacteria were identified by disk diffusion ESBLs assay. Extended-spectrum 尾 -lactamases were obtained from Pseudomonas aeruginosa to extract bacterial plasmid DNA and chromosome DNA. The type of ESBLs gene was detected by PCR test. Results Sixty-four strains of Pseudomonas aeruginosa were isolated from clinical specimens. The results of antibiotic sensitivity test showed that they were resistant to penicillin, first and second generation cephalosporins. The resistance rates of cephalomycin antibiotics cefoxitin and compound sulfanilamide were higher than 90%, and the resistance rate to the third generation cephalosporins ranged from 20% to 50%. The resistance rate to imipenem was 15.6; The resistance rate of ticacillin / clavulanic acid to the compound preparation of enzyme inhibitor was 20.3; The resistance rates of ciprofloxacin and ciprofloxacin to aminoglycoside antibiotics were 32.8% and 29.77.There were 27 strains of Pseudomonas aeruginosa confirmed by disk diffusion ESBLs assay. Extended-spectrum 尾 -lactamases were produced. The drug resistance of ESBLs producing and non ESBLs producing strains was compared. ESBLs producing strains were resistant to piperacillin, cefoperazone and ceftriaxone. The drug resistance rate of ceftazidime and aztreonam was significantly higher than that of non-producing ESBLs strains (P < 0.05). TEM type genes were found in plasmid DNA and chromosome DNA of 20 strains of Pseudomonas aeruginosa. OXA-10 type gene was detected in plasmid DNA of 4 strains of Pseudomonas aeruginosa and OXA-10 type gene was found in DNA of 2 strains of bacteria. TEM type gene and OXA-10 type gene were detected in plasmid DNA of one strain of bacteria. Conclusion the drug resistance of Pseudomonas aeruginosa to antibiotics in our hospital is different from that in other regions of China. The ESBLs production rate of Pseudomonas aeruginosa infection in our hospital is higher. TEM type enzyme and OXA-10 type enzyme were detected, and TEM type enzyme was more frequently. Pseudomonas aeruginosa encodes ESBLs gene on plasmid DNA and also on chromosome DNA. The resistance of Pseudomonas aeruginosa to the third generation of cephalosporins was complex and diverse, and the mechanism of resistance to the third generation cephalosporins was mainly ESBLs production. Diagram [11 / Table. [7] reference. [54]
【學(xué)位授予單位】：安徽理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類(lèi)號(hào)】：R378.99

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