耐亚胺培南铜绿假单胞菌的耐药性分析及金属β-内酰胺酶检测

Imipenem-resistant Pseudomonas aeruginosa and Detection of Metallo-β-lactamase

目的 了解耐亚胺培南铜绿假单胞菌的耐药谱及产金属β-内酰胺酶情况。方法 K-B法测定铜绿假单胞 菌对10种抗菌药物的耐药性;亚胺培南纸片法测定铜绿假单胞菌产金属β-内酰胺酶。结果 194株铜绿假单胞 菌中44株(22.9％)对亚胺培南耐药,这44株菌对哌拉西林、头孢他啶、头孢哌酮、左氧氟沙星耐药;对阿米卡星 耐药率相对较低;对头孢哌酮／舒巴坦、头孢吡肟、环丙沙星部分敏感;对亚胺培南耐药的44株铜绿假单胞菌金属 β-内酰胺酶检出率为11.3％。结论 产金属β-内酰胺酶是铜绿假单胞菌对亚胺培南及头孢类抗生素耐药的机制 之一,治疗耐亚胺培南铜绿假单胞菌引起的感染宜参考实验室的细菌药敏结果选用较敏感的四代头孢或环丙沙 星结合头孢哌酮／舒巴坦联合用药;实验室提高对其检出可帮助临床合理选用抗菌药物并减少耐药性的传播。

OBJECTIVE To evaluate the spectrum of imipenem-resistant Pseudomonas aeruginosa and the production of metallo-β-lactamase. METHODS P. aeruginosa resisted to 10 sorts of antimicrobials was detected by K-B method; the production of metallo-BBBBBBBBBB-lactamase was tested by imipenem-paper method. RESULTS Forty four (22.9%) among 194 strains were imipenem-resistant. They were also resistant to piperacillin, ceftazidime, cefoperazone, and levofloxacin, meanwhile, amikacin was less resistant than others, cefepime/ciprofloxacin was partly susceptible; 11. 3% of metallo-β-lactamase were detected in these 44 strains of imipenem-resistant P. aeruginosa. CONCLUSIONS The production of metallo-β-lactamase is one of the mechanisms of P. aeruginosa resistant to imipenem and cephems. To treat the infection of imipenem-resistant P. aeruginosa should rely on the resistant spectrum from laboratory and select the cephems or ciprofloxacin in combinations with cefoperazone ; correct detection in lab is important for application of antimicrobials and decrease of the prevalence of bacterial resistance.