产β-内酰胺酶脑膜炎败血黄杆菌筛选及耐药性分析

Screening of metallo-β-lactamase-producing and extended-spectrum β-lactamase-producing isolates of chryseobacterium meningosepticum and analysis of drug resistance

目的:检测近3a来从临床标本中分离的产金属β-内酰胺酶(MBL)、超广谱β-内酰胺酶(ESBL)脑膜炎败血黄杆菌以及其耐药性状况,指导临床正确合理使用抗生素。方法:用API20-NE对菌株进行鉴定;双纸片协同试验和增效试验筛选金属β-内酰胺酶;双纸片协同试验及表型确认试验筛选超广谱β-内酰胺酶;药敏试验采用K-B法。结果:脑膜炎败血黄杆菌的产酶率为55.6%(40/72),其中金属β-内酰胺酶为37.5%(27/72),超广谱β-内酰胺酶为19.4%(14/72),1株同时产金属β-内酰胺酶和超广谱β-内酰胺酶。左氧氟沙星、环丙沙星、阿米卡星和利福平的耐药率分别为26.4%、33.3%、30.6%和33.3%。结论:增效试验和双纸片协同试验筛选产MBL菌株以及双纸片协同试验筛选产ESBL菌株,方法简单,适合各等级医院。阿米卡星、左氧氟沙星、环丙沙星和利福平是治疗脑膜炎败血黄杆菌感染的最有效药物。

Aim: To investigate the metallo GAAB2 β-lactamase-producing and extended GAAB2 spectrum β-lactamase-producing clinical isolates of chryseobacterium meningosepticum(CM) and drug resistance in recent three years so as to guide the rational application of antibiotics.Methods: Identification of bacteria was conducted with API20-NE.Metallo-β-lactamase-producing isolates were screened by double-disk synergy test and double-disk enhancement test; extended-spectrum β-lactamase GAAB2 producing isolates were screened by double-disk synergy test and phenotypic confirmatory test. Antimicrobial sensitivity of clinical isolates was tested by Kirby-Bauer method. Results: The rate of producing β-lactamases of CM clinical isolates was 55.6%(40/72), the rate of producing mtallo-β-lactamase of cm clinical isolates was 37.5%(27/72),and the rate of proclucing of CM the extended-spectrumβ-lactamase clinical isolates was 19.4%(14/72), respectively. One clinical isolate produced metallo-β GAAB2 lactamase and extended-spectrum β-lactamase.The resistant rates of CM clinical isolates to levofloxacin, ciprofloxacin, amikacin,and rifampicin were 26.4%,33.3%,30.6%,and 33.3%, respectively. Conclusion: The double-disk synergy test and the double GAAB2 disk enhancement test are suitable for screening mtallo-β-lactamase-producing isolates; the double GAAB2 disk synergy test is suitable for screening extended-spectrum β-lactamase-producing clinical isolates in hospitals. Amikacin, levofloxacin, ciprofloxacin and rifampicin are the most effective agents in treatment of the infection conditions caused by CM clinical isolates in the hospital.