鲍曼不动杆菌的耐药性及产ESBL和碳青霉烯酶分析

Analysis on resistance of Acinetobacter Baumannii and the extended spectrum beta-lactamases and carbapenemases

目的:分析我院鲍曼不动杆菌的耐药性及产超广谱β-内酰胺酶(ESBL)和产碳青霉烯酶情况。方法:K-B法进行药物敏感试验,运用表型确证试验检测ESBL,改良Hodge试验检测碳青霉烯酶。结果:135株鲍曼不动杆菌中,对亚胺培南和美罗培南的耐药率高达72.6%,对阿米卡星、头孢噻肟等10种抗菌药物耐药率为61.5%～100.0%,对头孢哌酮/舒巴坦的耐药率最低为34.8%,其次是左氧氟沙星耐药率为54.1%。其中有22株检出ESBL占16.3%;46株检出碳青霉烯酶占34.1%。结论:我院鲍曼不动杆菌耐药率高,应加强细菌检测和药敏试验,指导临床合理应用抗菌药物。对于临床经验用药建议选用头孢哌酮/舒巴坦;鲍曼不动杆菌对β-内酰胺类药物耐药可能与产ESBL和碳青霉烯酶有关。

ABSTRACT AIM. To analyze drug resistance of Acinetobacter Baumannii and detect the rate of extended spectrum beta-lactamases and carbapenemases which produced by Acinetobacter Baumannii in the hospital. METHODS： The disk diffusion method （K-B） for drug susceptibility testing was used, Clinical and Laboratory Stand- ards Institute （CLSI） was taken for determing ESBL, the carbapenemases was modified by Hodge test. RESULTS：The susceptibility test to antibioties showed the resistance rates were 72.6% to Imipenem and Meropenem, 61.5%- 100% to 10 antibioties including Amikacin and Cefotaxime, 34.8% to Cefoperazone/Sulbactam, 54.1% to Levofloxacin. In 135 strains,there were 22 produced ESBL（16.3%）, 46 pro- duced carbapenemases （34.1%）. CONCLUSION ： The drug resistance rate of Acinetobaeter Bau- mannii is high in the hospital, it should be inten- sified in bacterium detection and drug suscepti- bility test to guide clinical drug usage more reasonability. Cefoperazone/Sulbactam will be ad vised as clinical experience of medication. The resistance to betalactam in Acinetobacter Bau- mannii is possibly related to ESBL and carbapenemases.