【摘要】 目的探讨新疆地区临床分离的铜绿假单胞菌产金属β-内酰胺酶、外排泵Mex AB-oprM和外膜蛋白OprD2表达水平及其与碳青霉烯类抗菌药物耐药性之间的关系。方法聚合酶链反应(PCR)和测序法分别检测1~4组铜绿假单胞菌的金属β-内酰胺酶;RT-PCR检测1、2、4组铜绿假单胞菌外排泵Mex AB-oprM和孔蛋白OprD2的表达水平。结果含亚胺培南耐药和美罗培南耐药组均有≥42.9%检出亚胺培南(IMP)、VIM金属酶基因型;OprD2显著低于表达在亚胺培南与美罗培南同时耐药组(87.5%),高于亚胺培南与美罗培南同时敏感组(20.0%),差异有统计学意义;Mex AB-oprM在各组中分别有60.0%、57.1%、37.5%的高表达,差异无统计学意义。结论外膜的低通透性、金属β-内酰胺酶的水解和主动外排泵过度表达,三者相互协同作用是该地区耐碳青霉烯类铜绿假单胞菌的主要机制。更多还原

【Abstract】 OBJECTIVE To investigate the relationship between the isolates of Pseudomonas aeruginosa producing Metallo-β-lactamases,efflux pump MexAB-oprM as well as the outer membrane protein oprD2 expression and carbapenems antibiotic resistance from clinical in Xinjiang region.METHODS Polymerase chain reaction(PCR) and sequencing were used to detect Metallo-β-lactamases in 1,2,3 and 4 group respectively;RT-PCR was used to detect efflux pump MexAB-oprM and the outer membrane protein expression levels of oprD2 in 1,2 and 4 group respectively.RESULTS More than 42.9% of strains of imipenem-resistant and meropenem-resistant group were found to be two kinds of metal enzyme genotype about imipenem and VIM;OprD2 significantly lower expression of imipenem and meropenem-resistant group(87.5%) was higher than that of imipenem and meropenem-sensitive group(20.0%),P<0.05;high level expression of MexAB-oprM was in each group 60.0%,57.1% and 37.5%,the differences were not statistically significant(P>0.05).CONCLUSION The synergy of low permeability of outer membrane,the metallo-β-lactamase hydrolysis and active efflux pump over-expression is the main mechanism for P.aeruginosa resistant to carbapenem antibiotics in Xinjiang region.更多还原