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Sensitivity and Mechanisms of Drug Resistance to Carbapenem-resistant Pseudomonas Aeruginosa

Author: YangZhiYong
Tutor: HuSiHai
School: Nanhua University
Course: Pathogen Biology
Keywords: Pseudomonas aeruginosa Carbapenem antibiotic Drug resiatance Metallo-β-lactamas Multi-drug efflux pump
CLC: R446.5
Type: Master's thesis
Year: 2011
Downloads: 30
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Abstract


(57.3%), wound secretion(22.7%), pus (6.7%)and other samples(13.3%).(3)Sensitivity to antibiotics: Susceptibility results showed that 75 strains of Pseudomonas aeruginosa resistant to carbapenem antibiotics has three drug resistance patterns: both imipenem and meropenem resistant (IMI~RMERO~R), resistant to imipenem and meropenem-sensitive(IMIRMEROS), imipenem-sensitive and resisitant to Meropenem(IMI~SMERO~R).Susceptibility results to 12 kinds of antibiotics showed that the resistance rates of all were: polymyxinE<ciprofloxacin<amikacin<cefepime<tobramycin< gentamicin <meropenem < ceftazidime < piperacillin /tazobactam <imipenem<cotrimoxazole <ampicillin / sulbactam.(4)Homology analysis:By ERIC-PCR analysis of homology among 75 strains of Pseudomonas aeruginosa resistant to carbapenems, the results showed 8 types totally, of which the main type is A- type and B-type, respectively accounting for 34.7% (26 stra- ins ) and 22.7%(17 strains).(5)Metallo-β-lactamase test:Imipenem-EDTA increased sensitivity paper Synergism test showed in the 75 strains resistant to carbapenems , 13 strains were positive in metal enzymes test ,as well as in EDTA synergy test ,accounting for17.3%.(6)Efflux pump inhibition test:The results of Efflux pump inhibition test showed that MC207110 ,which known as the efflux pump inhibitor, can make the MIC values of meropenem in 34 strains resistant to meropenem decreas by 4 times or more, when com- pareed with single drug thrapy, accounting for 63.0%.Conclusions:(1)Pseudomonas aeruginosa infection in hospitals play an important role in the pathogen,second only to E. coli.And the resistance Of imipenem and meropenem and other carbapenems has shown signs of growing momentum.(2) The majority of samples obtained in patients with Pseudomonas aeruginosainfection was composed of sputum,most strains were isolated from Intensive Care Unit and neurosurgery department and other wards. (57.3%), wound secretion(22.7%), pus (6.7%)and other samples(13.3%).(3)Sensitivity to antibiotics: Susceptibility results showed that 75 strains of Pseudomonas aeruginosa resistant to carbapenem antibiotics has three drug resistance patterns: both imipenem and meropenem resistant (IMI~RMERO~R), resistant to imipenem and meropenem-sensitive(IMIRMEROS), imipenem-sensitive and resisitant to Meropenem(IMI~SMERO~R).Susceptibility results to 12 kinds of antibiotics showed that the resistance rates of all were: polymyxinE<ciprofloxacin<amikacin<cefepime<tobramycin< gentamicin <meropenem < ceftazidime < piperacillin /tazobactam <imipenem<cotrimoxazole <ampicillin / sulbactam.(4)Homology analysis:By ERIC-PCR analysis of homology among 75 strains of Pseudomonas aeruginosa resistant to carbapenems, the results showed 8 types totally, of which the main type is A- type and B-type, respectively accounting for 34.7% (26 stra- ins ) and 22.7%(17 strains).(5)Metallo-β-lactamase test:Imipenem-EDTA increased sensitivity paper Synergism test showed in the 75 strains resistant to carbapenems , 13 strains were positive in metal enzymes test ,as well as in EDTA synergy test ,accounting for17.3%.(6)Efflux pump inhibition test:The results of Efflux pump inhibition test showed that MC207110 ,which known as the efflux pump inhibitor, can make the MIC values of meropenem in 34 strains resistant to meropenem decreas by 4 times or more, when com- pareed with single drug thrapy, accounting for 63.0%.Conclusions:(1)Pseudomonas aeruginosa infection in hospitals play an important role in the pathogen,second only to E. coli.And the resistance Of imipenem and meropenem and other carbapenems has shown signs of growing momentum.(2) The majority of samples obtained in patients with Pseudomonas aeruginosainfection was composed of sputum,most strains were isolated from Intensive Care Unit and neurosurgery department and other wards. (3)The susceptibility results suggest that in treatment of patients with severe Pseudom- onas aeruginosa infection, polymyxin E is a good alternative drugs, the second is ciprofloxacin.(4) There are mainly two kinds of cloning exist in Pseudomonas aeruginosa resistant to carbapenems ,which Separated from our hospital(mostly from the south of Hunan Pro- vince).(5)Production of metallo-β-lactamase may cause antibiotic resistance to carbapenems in Pseudomonas aeruginosa, but not the main mechanism.(6)Multi-drug resistant efflux system may exist in Pseudomonas aeruginosa.

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