|本期目录/Table of Contents|

[1]黄 梅,奚海燕,王 颖,等.耐喹诺酮的铜绿假单胞菌药物外排泵研究[J].医学研究与战创伤救治(原医学研究生学报),2015,17(06):583-586.[doi:10.3969/j.issn.1672-271X.2015.06.007]
 HUANG Mei,XI Hai-yan,WANG Ying,et al.Study on the efflux pump of quinolone resistantpseudomonas aeruginosa drugs[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2015,17(06):583-586.[doi:10.3969/j.issn.1672-271X.2015.06.007]
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耐喹诺酮的铜绿假单胞菌药物外排泵研究()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
第17卷
期数:
2015年06期
页码:
583-586
栏目:
出版日期:
2015-12-15

文章信息/Info

Title:
Study on the efflux pump of quinolone resistantpseudomonas aeruginosa drugs
作者:
黄 梅奚海燕王 颖潘 红范 明胡毓安史利宁王卫萍邵海枫
210002 江苏南京,南京军区南京总医院全军检验医学研究所
Author(s):
HUANG Mei XI Hai-yan WANG Ying PAN Hong FAN Ming HU Yu-anSHI Li-ning WANG Wei-ping SHAO Hai-feng.
PLA Institute of Laboratory Medicine, Nanjing General Hosptial of Nanjing Military Command,PLA,Nanjing, Jiangsu 210002,China
关键词:
铜绿假单胞菌环丙沙星左氧氟沙星耐药机制外排系统
Keywords:
pseudomonas aeruginosa ciprofloxacin levofloxacin efflux system resistance mechanis
分类号:
R96
DOI:
10.3969/j.issn.1672-271X.2015.06.007
文献标志码:
A
摘要:
目的 探讨外排系统在对喹诺酮类药物耐药的铜绿假单胞菌中所起的作用。方法 用含亚抑菌浓度(20 mg/L)外排泵抑制剂羰基氰化氯苯腙(carbonyl cyanide 3-chlorophenylhydrazone,CCCP)的MH平板和不含泵抑制剂的MH平板分别检测对环丙沙星的MIC值,比较MIC值是否不同;MIC值降低的菌株用RT-PCR检测外排泵蛋白基因表达量的变化,用PCR和测序法了解调控外排泵蛋白表达的基因是否存在改变。结果 14株铜绿假单胞菌的外排泵存在过度表达,环丙沙星的MIC值降低至原值的1/2~1/8,以mexAB-OprM和mexCD-OprJ表达增加为主,调控mexAB-OprM基因的MexR有V126E突变, mexCD-OprJ的调控基因NfxB有H109Y突变。结论 外排泵的高表达在喹诺酮耐药的铜绿假单胞菌中存在近50%,高于所见国内外的报道。该机制与药物作用靶位改变共同提高了铜绿假单胞菌对喹诺酮类的耐药,外排泵的高表达同时也提升了该菌对头孢吡肟等其他药物的耐药,是需要密切关注和采取相应措施的流行趋势。
Abstract:
Objective This study aims to investigate the efflux system in fluoroquinolone resistance of pseudomonas aeruginosa. Methods MIC values of ciprofloxacin were detected by MH flat containing sub-inhibitory concentration (20 mg/L) efflux pump inhibitor carbonyl cyanide chlorophenylhydrazone (carbonyl cyanide 3-chlorophenylhydrazone, CCCP) and MH flat without CCCP. Then compare the MIC. Results Efflux pump in 14 strains of pseudomonas aeruginosa was overexpressed, which were mainly mexAB-OprM and mexCD-OprJ. MIC value of ciprofloxacin decressed 1/2-1/8 times. MexR regulated by mexAB-OprM existed V126E mutation and NfxB regulated by mexCD-OprJ existed H109Y mutation. Conclusion The efflux pump is overexpressed in nearly 50% of fluoroquinolone resistant strains of pseudomonas aeruginosa, which is higher than the domestic and foreign reports. The mechanism and drug target change improve the resistance of pseudomonas aeruginosa to fluoroquinolones. The overexpression of efflux pump also enhance the resistance of the bacteria to cefepime and other drugs (this is not listed), which need us pay close attention and take measures to control this trend.

参考文献/References:

[1] 王 颖,黄 梅,奚海燕,等.耐喹诺酮铜绿假单胞菌药物作用靶位改变的研究[J].现代检验医学杂志,2014,29(6):18-20. [2] Bhavnani SM,Callen WA,Forrest A,et al. Effect of fluoroqulnolone Expenditures on susceptiblity of Pseudomon asaeruginosa to ciprofloxacin in U.S.hospitals [J]. Am J Health Syst Pharm,2003,60(19): 1962-1970. [3] 刘文广,戴路明.铜绿假单胞菌对喹诺酮类抗菌药物的耐药机制[J].医学综述,2012,11(18):1650-1652. [4] Drlica K,Malik M. Fluoroquinolones:action and resistance [J].Curr Top Med, 2003,3(3):249-282. [5] McCay PH, Ocampo-Sosa AA, Fleming GT. Effect of subinhibitory concentrations of benzalkonium chloride on the competitiveness of Pseudomonas aeruginosa grown in continuous culture[J]. Microbiology, 2010, 156(Pt1):30-38. [6] Linares JF, López JA, Camafeita E, et al. Overexpression of the multidrug efflux pumps MexCD-OprJ and MexEF-OprN is associated with a reduction of type III secretion in Pseudomonas aeruginosa [J]. J Bacteriol, 2005, 187(4):1384-1391. [7] Hammami S,Ghozzi R,Burghoffer B,et al. Mechanisms of carbapenem resistance in non-metallo-beta-lactamase-producing clinical isolates of Pseudomonas aeruginosa from a Tunisian hospital[J]. Pathol Biol (Paris),2009,57(7-8):530-535. [8] Pasca MR, Dalla Valle C,De Jesus Lopes Ribeiro AL, et al. Evaluation of fluoroquinolone resistance mechanisms in Pseudomonas aeruginosa multidrug resistance clinical Isolates [J]. Microb Drug Resist, 2012, 1(18):23-32. [9] 刘 洋,李方法,蒋伟燕,等.外排泵MexAB-OprM在多重耐药铜绿假单胞菌中的作用[J].中国卫生检验杂志,2010,4(20):830-833. [10] Laurent P,Vincent C, Patrice N,et al.Plasmid-mediated quinolone resistance determinants among enterobacterial isolates from outpatients in Brazil[J]. J Antimicrob Chemother, 2008,62(3):474-478. [11] Anna F,Sergi M,Ernest G,et al.Mechanism of action of and resistance to quinolones[J]. Microb Biotechnol, 2009,2(3):40-61. [12] 杨晓燕,张永标,梁彩倩,等.质粒介导铜绿假单胞菌对喹诺酮类耐药机制的研究[J].中华医院感染杂志,2013,11(23):2524-2526. [13] 黄 梅,王 颖,王卫萍,等.两种吸附抗生素血培养瓶对血流感染检测能力的比较[J].东南国防医药,2014,16(2):117-120.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2015-11-20