杭州市区铜绿假单胞菌对亚胺培南与美罗培南耐药模式的研究

The Imipenem and Meropenem resistance patterns observed in Pseudomonas aeruginosa clinical isolates from hangzhou downtown hospitals.

目的了解杭州市区铜绿假单胞菌对亚胺培南与美罗培南不同耐药模式菌株对临床常用其他抗菌药物的耐药情况。方法选取2006年8月至2007年1月杭州市4家医院分离的铜绿假单胞菌378株,对不同城区分离的铜绿假单胞菌进行药物敏感性检测,对亚胺培南与美罗培南不同的耐模式菌株进行分类统计,同时观察其对其他抗菌药物的耐药率。结果在378株细菌中观察到亚胺培南与美罗培南的8种耐药模式,分别为S/S,66.1%(250/378);R/R,20.6%(78/378);S/R,5.0%(19/378);R/S,3.4%(13/378);I/R,1.9%(7/378);R/I,1.3%(5/378);I/S,1.1%(4/378);S/I,0.5%(2/378)(S为敏感,I为中介,R为耐药)。对其他8种抗菌药物的敏感性检测结果显示,S/S与S/I及I/S模式耐药性最低,均低于10%,R/R最高,均高于44%。R/S与S/R模式对不同的抗菌药物耐药率有较大不同。结论杭州市区流行的菌株以S/S,R/R,S/R,R/S 4种模式为主,占所有模式中的95%以上,其中又以S/S模式最为多见,不同模式菌株对其他抗菌药物的耐药性有较大差异,临床可通过不同的耐药模式进行耐药机制推断,合理选用抗菌药物治疗。

Objective To understand the different resistance patterns in the imipenem and meropenem different rsistance patterns in Pseudomonas aernginosa clinical isolates from hangzhou downtown hospitals in order to confirm the popularity resistant strains in this area, to help using drug of clinic. Methods To accumulate 378 strains of Pseudomonas aeruginosa from 5 hospitals in hangzhou downtown, to detect the antimicrobial susceptibility by K-B methods. Classified the he imipenem and meropenem rsistance patterns, then analysed the resistance to other antimicrobial agents according as the different rsistance pattern. Results In 378 strains of Pseudomonas aernginosa, we found 8 typies different rsistance pattern, S/S,66.0% （250/378） ;R/R,20. 5% （78/378） ;S/R,5.5% （19/378） ;R/S,3.4% （13/378） ;I/R,1.8% （7/378） ;R/ I, 1.3% （5/378） ;I/S, 1.0% （4/378） ;S/1,0. 5% （2/378）, respectively. For these patterns, the resistant rate to the other antimicrobial agents were all under 10% was S/S,S/I and I/S;the R/R pattern was highest,over 44%. The R/S and S/ R patterns have more different resistant rate for different antimicrobial agents. Condtmion The 4 typies of S/S, R/R, S/ R and R/S resistance patterns was giving priority to, over 95% in all typies, and, the most pattern was S/S. The isolates which different resistance patterns have different resistance to other antimicrobial agents. To detect imipenem and meropenem different rsistance pattern may help using drug in clinic.