洋葱伯克霍尔德菌耐药性和金属β-内酰胺酶的检测

Determination of Antimicrobial Resistance and Metallo-β-Lactamases of 75 Burkholderia cepacia Clinical Isolates

目的探讨洋葱伯克霍尔德菌耐药情况及其多重耐药特点。方法用微量琼脂稀释法检测2004年1月至2006年12月临床分离不重复75株洋葱伯克霍尔德菌对15种抗菌药物的抗菌活性及其产金属β-内酰胺酶情况,比较产酶株与非产酶株抗药活性。结果2004-2006年洋葱伯克霍尔德菌检出率呈上升趋势,痰标本分离率较高。感染者分布于临床各个科室,并患有各种严重基础疾病,并使用过抗菌药物。葱伯克霍尔德菌对多数抗菌药物耐药,仅对复方新喏明、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他巴唑坦敏感,敏感率分别为95%、82.8%、74.7%、70.7%;而对头孢噻肟、头孢哌酮、头孢曲松、阿米卡星、氨曲南、哌拉西林耐药率超过50%。产金属β-内酰胺酶株与非产金属β-内酰胺酶株比较,产酶株对含酶抑制剂β-内酰胺类抗生素敏感性较高。结论洋葱伯克霍尔德菌对多数抗菌药物耐药,仅对复方新喏明、头孢哌酮/舒巴坦、美罗培南、哌拉西林/他巴唑坦敏感,建议临床医生根据药敏试验合理用药,以减少耐药菌株的产生。

Objective To investigate antimicrobial resistance of Burkholderia cepacia isolated from hospitalized patients and metallo-β-Lactamases （MBLs） production in these clinical isolates. Method Burkholderia cepacia strains were collected from 75 hospitalized patients in the Seventh Hospital of Shengzhen. A microdilution Broth method was used to detect Burkholderia cepacia MIC and metallo-β-Lactamases production. Result The detection rate of Burkholderia cepacia increases year by year from 2004 to 2006. Burkholderia cepacia infected patients were occurred in clinical departments and these patients were all having serious diseases and had been treated with antibiotics. The majority of 75 strains were multidrug resistant, but these strains showed higher susceptibity to trimethoprim-sulfamethoxaz, cefoperazone/sulbactam, meropemem and pipacillin/tazobactam than other antibiotics, with the rate of susceptibility of 95%, 87.4%, 82.8%, and 80.8%, respectively. The rate of resistance to cefotaxime, cefoperazone, ceftriaxone, amikacin, piperacillin and aztreonam were more than 50%.11 MBLs-producing strains were detected. Compared with non β-Lactamases producing strains, the β-Lactamases producing strains showed higher susceptibility to antibiotics with β-Lactamases inhibitors. Conclusion Burkholderia cepacia clinical isolates were resistant to many antibiotics and only susceptible to trimethoprim-sulfamethoxaz, cefoperazone/sulbactam, meropemem and pipacillin/tazobactam. Clinicians should therefore choose suitable antibiotics according to the drug resistant test of the isolates.