Zarakolu Pinar, Metan Gökhan, Gürkan Aydin Nazli, Altun Belgin, Hasçelik Güłşen, Akova Murat
Hacettepe Universitesi Tip Fakültesi, iç Hastaliklan Anabilim Dali, Enfeksiyon Hastaliklari Unitesi, Ankara.
Mikrobiyol Bul. 2007 Jul;41(3):363-7.
The aim of this study was to determine the frequency of PER-1 type extended-spectrum beta-lactamase (ESBL) in nosocomial Pseudomonas aeruginosa strains isolated in Hacettepe University Adult Hospital. Sixty-seven non-duplicate P. aeruginosa isolates from patients with nosocomial infections between January 2002 and December 2004 were included in the study. The isolates were identified at species-level by Sceptor (Becton Dickinson, USA) system, and all the strains were stored at -80 degrees C until further testing. Polymerase chain reaction (PCR) was performed for the detection of (bla)PER-1 genes, and PFGE analysis was used to investigate their genetic relatedness. The antimicrobial susceptibilities of the PER-1 positive isolates were determined by Etest (AB Biodisk, Solna, Sweden) method. According to the results of PCR, 22.7% (15/67) of the isolates were positive for PER-1 enzyme. Those 15 (bla)PER-1 positive isolates showed eight different PFGE patterns, indicating the presence of multiple clones. Of the PER-1 positive P. aeruginosa isolates, nine were resistant to imipenem/meropenem, and 11 were resistant to piperacillin-tazobactam and tobramycin. The epidemiological investigation of multidrug resistant P. aeruginosa should give important clues for the initial empirical therapy, especially in certain geographic locations where ESBL-producing P. aeruginosa strains seemed to be highly prevalent.
本研究的目的是确定在哈杰泰佩大学成人医院分离出的医院内感染铜绿假单胞菌菌株中PER-1型超广谱β-内酰胺酶(ESBL)的出现频率。研究纳入了2002年1月至2004年12月期间医院感染患者的67株非重复铜绿假单胞菌分离株。通过Sceptor(美国BD公司)系统在种水平上鉴定分离株,所有菌株均保存在-80℃直至进一步检测。采用聚合酶链反应(PCR)检测(bla)PER-1基因,并通过脉冲场凝胶电泳(PFGE)分析研究其遗传相关性。采用Etest(瑞典索尔纳AB Biodisk公司)方法测定PER-1阳性分离株的抗菌药敏性。根据PCR结果,22.7%(15/67)的分离株PER-1酶呈阳性。这15株(bla)PER-1阳性分离株显示出8种不同的PFGE图谱,表明存在多个克隆。在PER-1阳性的铜绿假单胞菌分离株中,9株对亚胺培南/美罗培南耐药,11株对哌拉西林-他唑巴坦和妥布霉素耐药。对多重耐药铜绿假单胞菌的流行病学调查应为初始经验性治疗提供重要线索,尤其是在产ESBL铜绿假单胞菌菌株似乎高度流行的某些地理位置。