急性有机磷中毒医院肺炎致病菌多重耐药研究

Study of Multiple-Drug Resistance of Bacterial Strains Isolated From Patients with Pneumonia Due to Organophosphate Poisoning

目的研究急性有机磷中毒医院肺炎患者多重耐药性致病菌(multi-drug resistant bacteria,MDR)的种类、分布状况以及耐药特点。方法采用实验方法筛选多重耐药菌株,研究其分布特点和耐药规律。结果2002年1月-2006年7月共分离出多重耐药性致病菌31株,其中以铜绿假单胞菌最多,其次为鲍曼不动杆菌;各株MDR呈现出多重耐药性。MDR中,以产ESBLs(Extented spectrurn beta lactamases,超广谱β-内酰胺酶)菌为主,其后依次为产金属酶细菌、产AmpC酶(头孢菌素酶)和SSBLs菌(既产AmpC酶,又产ESBLs的菌株称为SSBLs),革兰氏阳性MDR为MRS。结论急性有机磷中毒医院肺炎患者的MDR感染率较高,造成治疗上的困难,因此必须科学合理地使用抗菌药物,减少MDR的感染率。

Objective To study the multiple-drug resistance （MDR） of bacterial strains isolated from patients with pneumonia due to organophosphate poisoning. Methods Different MDR strains were isolated from inpatients with pneumonia due to organophosphate poisoning, and their distributions and characteristics of drug resistant were studied. Results Thirty-one strains of MDR were isolated from patients. Most of the MDR strains were P. aeruginosa,the next was A. baumannii, Most of these strains produce ESBLs. AmopcE -producing strain and SSBLs-producing strain were very common,too, Gram positive MDR stain were all MRS. Conclusions Patients with acute organophosphate poisoning have a high infection rate of MDR. This kind of pneumonia is difficult to be cured, therefore, antibiotics must be adopted properly to decrease the infection rate of MDR strains.