Distribution And Drug Resistance In Ningxia Clinical Multidrugresistant Pseudomonas Aeruginosa

ObjectiveTo investigate the clinical distribution and antimicrobial drug resistance of P. aeruginosa to explore its possible mechanism to generate multi-drug resistant infections homology and molecular level, so as to effectively prevent and control of multidrug-resistant Pseudomonas aeruginosa Aeromonas infection provide scientific reference.Methods1. Collect and save the Affiliated Hospital of Ningxia Medical University, the period from September 2011 to September 2012 PA non-repetitive strains of285 clinical isolates with French Merieux automated microbial analyzer(VITEK 2 COMPACT) identification of bacteria; adoption KB was detected in clinical isolates of Pseudomonas aeruginosa 14 kinds of commonly used antibiotics for drug susceptibility testing, application software for these drugs WHONET5.6 sensitive results were analyzed, screened multi-drug resistant Pseudomonas aeruginosa.2. The MDRP screened 124 strains by efflux pump inhibitor reserpine carbenicillin, erythromycin, gentamicin, imipenem and agar dilution method to detect inhibition tests were Pseudomonas aeruginosa the Mex AB-Opr M, Mex CD-Opr J, Mex EF-Opr N, Mex XY-Opr M efflux pump four phenotypes, after adding reserpine simultaneous detection of four drugs for P. aeruginosa MIC values change; polymerase chain technical detection reaction(PCR) efflux pump gene.3. The MDRP screened 124 strains detected by PCR integrase gene, will continue IntⅠ strains tested positive by PCR amplification of variable regions; using PCR-RFLPF analyze and determine the type of the variable region of the strain.4.Pulsed field condensate gel electrophoresis(PFGE) technique for multi-drug resistant Pseudomonas aeruginosa homology analysis.Results1.From 2011 September to September 2012 in our hospital were isolated from 785 of Pseudomonas aeruginosa, the main source of sputum specimens(65.5%), mainly in the distribution de PArtment of ICU(34.7%), Children’s Emergency Center(16.8%) and Respiratory Diseases(9.5%) and other de PArtments. The results showed that resistance: clinical isolates of Pseudomonas aeruginosa to polymyxin B sensitive to imipenem, meropenem, piperacillin / tazobactam, ceftazidime has good sensitivity, in the empirical therapy clinic can choose the combination therapy; screened 124 MDRP also mainly from sputum(62.9%), mainly in the ICU(22.6%).2.Efflux pump phenotype positive results for: Mex AB-Opr M 74, Mex XY-Opr M 28, Mex EF-Opr N 12 strain and Mex CD-Opr J 10; 124 MDRP strains 74 Mex AB-Opr M efflux pump phenotype positive.3. Detection of which 124 MDRP Ⅰ integron positive strains have 87, not detected Ⅱ integron; 87 strains of gene-positive IntⅠ have 53 valid integron Ⅰamplified variable regions, by sequencing found six forms of resistance gene cassettes.4.124 MDRP on the pulse field gel electrophoresis(PFGE) analysis to obtain 8 genotypes.Conclusions1. In the commonly used antibiotics in Pseudomonas aeruginosa to polymyxin B the most sensitive clinical isolates of cotrimoxazole, cefotaxime highest resistance rates. The main source of sputum specimens, PA mainly in the ICU.2. Four kinds efflux pump most common phenotype is Mex AB-Opr M, it may be multidrug resistant Pseudomonas aeruginosa important mechanism.3. The multi-drug resistant Pseudomonas aeruginosa integron distribution types to classⅠintegron based. The integration of the sub-aminoglycoside modifying enzyme gene and the presence of β- lactams and multidrug resistance gene MDR P.aeruginosa are closely related.4.PFGE MDRP at the gene level to analyze the source of infection can be analyzed MDRP, transmission and distribution, for monitoring the prevalence of infection provide a reliable basis.