重症监护病房鲍曼不动杆菌头孢菌素类抗生素耐药性分析

The analysis of cephalosporin antibiotics on Acinetobacter baumannii in the intensive care unit

目的调查和研究鲍曼不动杆菌对头孢菌素类抗生素的耐药性及其与β-内酰胺酶基因型之间的关系。方法用KB法测定临床分离的120株鲍曼不动杆菌对6种头孢菌素类抗生素的耐药性,采用PCR法检测β-内酰胺酶耐药基因型。结果120株鲍曼不动杆菌对头孢哌酮/舒巴坦耐药率为7.5%,对头孢曲松耐药率为65.0%,对头孢吡肟和头孢他啶耐药率分别为61.7%和64.2%,对头孢唑啉和头孢呋肟耐药率分别为80.0%和97.5%;有80株菌检测到TEM型β-内酰胺酶基因,且均对头孢吡肟等抗生素耐药,其中2株为GES型,1株为VEB型,未检出CARB、DHA和PER基因。结论临床分离的120株鲍曼不动杆菌以TEM型为主,其对头孢菌素类抗生素的高耐药率与TEM型基因有直接关系。

Objective To investigate the resistance of cephalosporin antibiotics in Acinetobacterbaumannii and the main genotypes of beta lactamases in the I.iaoeheng district. Methods The Kirby-Bauer method was used to detect the resistance to six kinds of antimicrobial agents against 120 strains of A. baumannii. The main genotypes of beta-lactamases were assayed by PCR. Results Among the 70 strains of A. baumannii, the resistance rate to cefoperazone/sulbactam was 7, 1%, the resistance rate to ceftriaxone was 65.0%, and the resistance rates to cefepine and ceftazidime were 61.7% and 64.2%, respectively. The resistance rates to cefazolin and cefuroxime were more than 80.0%. TEM type beta lacta- mase genes were positive in all of the 80 isolates tested, which were multi drug resistant. The GES type beta-laetamase were positive in two strains, and the VEB type was founded in one strain. CARB, DHA and PER genes were not found in any isolates tested. Conclusion In the Liaocheng district, the TEM type beta lactamase is the main type in A. baumanniss and is related to high resistance to the beta-lactamase antibiotics.