carbapenem抗藥性綠膿桿菌之分子流行病學調查及其產生金屬性beta-環單醯酶盛行率研究
Date Issued
2005
Date
2005
Author(s)
王振泰
DOI
932314B002084
Abstract
Pseudomonas aeruginosa is a Gram-negative bacillus. It is intrinsically
resistant to many antimicrobial agents and one of the leading pathogens causing
nosocomial infections. According to the data from National Nosocomial Infection
Surveillance of USA, P. aeruginosa is the second leading pathogen of nosocomial
infection. In the longitudinal surveillance of nosocomial infection during a period of
20 years at National Taiwan University Hospital (NTUH), P. aeruginosa is always
one of the leading three nosocomial pathogens at NTUH. Given the fact of
intrinsically multi-drug resistance of P. aeruginosa, number of effective antibiotics
to treat infections caused by P. aeruginosa is limited. Carbapenem is one of the
major antibiotics to treat P. aeruginosa. However, more and more reports about
emergence of carbapenem-resistant P. aeruginosa in Japan, Italy, France, United
Kingdom, America, and so on, have been noted. This will further limit the choice of
effective antibiotics for P. aeruginosa.
The carbapenem resistance mechanism in P. aeruginosa is previously reported
to be associated with loss of OprD, existence of multidrug efflux pump, and
interplay between impermeability and chromosome-encoded β -lactamase. However,
recent reports from Japan, Italy, France, and United Kingdom demonstrate that this
resistance can be mediated by acquirement of a foreign metallo-β -lactamase, which
is encoded by an integron-borne gene element. The resistant gene can be transferred
between different bacteria and will lead to further spread of carbapenem resistance.
Therefore, integron-borne gene mediated carbapenem resistance, due to the
production of metallo-β -lactamase, has become a growing problem for microbiology
and clinical medicine. The present study investigated the moleculary epidemiology
and prevalence of metallo-β -lactamase producing in carbapenem resistant P.
aeruginosa collected at NTUH and TSAR study conducted by National Health Research Institute. We found that the isolates of carbapenem-resistant P. aeruginosa
remained polyclonal at NTUH and in Taiwan. The prevalence of
carbapenamase-production among carbapenem-resistant P. aeruginosa was 18%.
Subjects
Pseudomonas aeruginosa
carbapenem resistance
metallo-beta-lactamase
pulsed field gel electrophoresis
Publisher
臺北市：國立臺灣大學醫學院內科
Type
report
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