河源地区铜绿假单胞菌碳青霉烯耐药机制分析

Analysis of Carbapenem-resistant Mechanisms and Existing Circumstances of Drug Resistnce of Pseudomonas aeruginosa in Heyuan Distinct

目的研究本院铜绿假单胞菌耐碳青霉烯类抗生素的耐药现况及主要耐药机制。方法用E-test方法检测铜绿假单胞菌对哌拉西林、头孢他啶、亚胺培南、美洛培南、庆大霉素、妥布霉素、环丙沙星7种抗生素的最小抑菌浓度,用EDTA双纸片扩散法及三维实验分别对金属酶及AmpC、KPC酶表型进行确证。结果从1 068例致病菌中共分离出108例铜绿假单胞菌,18例是对亚胺培南和/或美罗培南不敏感的菌株,耐药率为16.7%,其中有9例金属酶确证实验阳性,3例为AmpC酶持续高产型菌株,KPC酶确证实验尚没有检测出阳性菌株。结论耐碳青霉烯类铜绿假单胞菌多表现为多重耐药,这是多因素共同作用的结果 。

Objective To understand the present situations and major mechanisms of the drug resistance to carbapenems of Pseudomonas aeruginosa strains in Heyuan,Guangdong province.Methods MICs of 7 antibiotic agents,including piperacillin,ceftazidime,imipenem,meropenem,gentamicin,tobramycin and ciprofloxacin were determined by E-test strips.Screening tests for detection of MBLs,KPC and AmpC by double disks synergy tests and 3-D tests respectively.Results 108 Pseudomonas aeruginosa clinical isolates were detected out of 1 068 clinical pathogenic bateria.18 strains were resistant to imipenem or meropenem,the drug-resistant rate occupied 16.7%.9 isolated strains were MBL producers by screening test and 3 strains showed presence of hyperexpression AmpC beta-lactamase.No strains produced KPC.Conclusion Most of carbapenem-resistant Pseudomonas aeruginosa are multidrug-resistant strains,this is due to cooperation of multiple genes and multiple factors.