铜绿假单胞菌感染耐药性及与β内酰胺酶的关系

Study on the drug-resistance of Psedomonas aeruginosa from elderly patients,and its relativity with producing-β-lactamases

目的研究本地区老年患者铜绿假单胞菌感染的分布特点及其耐药状况以及与产β-内酰胺酶的关系。方法采用K-B法测定亚胺培南等11种抗菌药物对182株铜绿假单胞菌及38株产β-内酰胺酶的铜绿单胞菌的体外抗菌活性。结果在临床分离的182株铜绿假单胞菌中,亚胺培南敏感性最高为85.71%,依次为头胞他啶(80.77%)、氨曲南(80.22%)、丁胺卡那(70.88%);在99株下呼吸道感染的铜绿假单胞菌中,亚胺培南的耐药率为24.24%,头孢他啶的耐药率为28.28%,明显高于其它部位;而在38株产β-内酰胺酶的铜绿假单胞菌中,耐药率最高的为哌拉西林(100%),其次为头孢唑啉(97.37%)和头孢噻肟(94.74%),明显高于非产酶株。结论铜绿假单胞菌感染中产β-内酰胺酶较为常见。产酶株铜绿假单胞菌的耐药性明显高于非产酶株铜绿假单胞菌的耐药性。其产生的β-内酰胺酶,是造成临床上铜绿假单胞菌对β-内酰胺类抗生素耐药的主要原因。

Objective To investigate the distributing characters of Pseudomonas aeruginosa infection in elderly patients and the drug- resistance, and its relativity with producing-β-lactamases.Method Antimicrobial activity to 182 strains of Pseudomonas aeruginosa and 99 strains Pseudomonas aeruginose of descend respiratory tract （including 38 strains β-lactamases of Psedomonas aeruginosa） were determined by K-B test,Result To the 182 strains of Pseudomonas aeruginose, the resistance of imipenem, ceftzidime, aztreonam were 85.71%, 80.77%, 80.22%, respectively; the susceptibility rate of amikacin was 70.88%. To the 99 strains Pseudomonas aeruginose of descend resperatory tract, the resistance of aztreonam, imipenem, amikacia were 81.82 %, 75.76%, 74.75%, respectively; the susceptibility rate of ceftazidime was 71.72%. To the 38 strains β-lactamases of Psedomonas aeruginosa, the resistance of aztreonam, imipenem, amikacin, ceftazidime were 78.95% 33.68% ,68.42% ,60.53%, respectively.Conclusion The production of β-laetamases in Psedomonas aeruginosa is more common. In the resistances of drugs about β-lactamases, such as piperacillin, cefazolin, ceftazidime,cefoperazone and eefotaxime, the resistance of Pseudomonas that produces lactamase is obviously higher than the ones which doesn＇t produce lactamases. They have prominent distinctions （P〈0.01）. Therefore, when doctors choose to use the antibiotics, it is essential to pcrfom the in vitro medical sensitivity experiment.