耐亚胺培南铜绿假单胞菌的耐药性分析及金属β-内酰胺酶的检测

Imipenem resistance pseudomonas aeruginosa drug resistance analysis and a metal beta lactamase detection

目的调查盐城市第一人民医院住院患者送检标本分离的铜绿假单胞菌对亚胺培南的耐药水平及其产金属β-内酰胺酶(MBLs)的情况。方法临床标本分离的铜绿假单胞菌采用法国生物梅里埃细菌鉴定及药敏检测系统进行细菌鉴定与药物敏感性试验;采用纸片协同实验来检测铜绿假单胞菌产金属β-内酰胺酶的情况。结果 236株铜绿假单胞菌中有63株对亚胺培南耐药,耐药率为26.69%,耐亚胺培南铜绿假单胞菌对阿米卡星、庆大霉素、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、环丙沙星、氨曲南部分耐药,耐药率分别为45.12%、50.33%、59.74%、61.43%、62.12%和63.16%;对头孢他啶、头孢吡肟、哌拉西林、美罗培南耐药率较高;63株耐亚胺培南铜绿假单胞菌金属β-内酰胺酶的检出率为38.10%(24/63)。结论金属β-内酰胺酶的产生是铜绿假单胞菌对碳青霉烯类抗生素耐药的重要机制之一,实验室应加强对产酶菌株的监测,为临床合理选用抗生素提供有效依据。

Objective To survey hospital inpatients samples of Pseudomonas aeruginosa＇s drug resistance to imipenem and the level of production of metal-β-lactamases （MBLs）. Methods Isolated from clinical specimens of pseudomonas aeruginosa were used French bioMerieux bacterial identification and susceptibility testing system for the identification of bacteria and drug sensitivity test of the slip,collaborative experiment was used detect Pseudomonas aeruginosa producing metal-β-1actamase situation. Results 63 of 236 pseudomonas aeruginosa had imipenem resist- ance,resistance rate was 26.69% ,imipenem-resistant pseudomonas aeruginosa for amikacin,gentamicin, piperacillin/ tazobactam, cephalosporinspiperazine ketone/sulbactam, ciprofloxacin first part of the resistance, resistance rates were 45.12 %, 50.33 %, 59.74 %, 61.43 %, 62.12 % and 63.16 %. Ceftazidime, cefepime, piperacillin, aztreonam, meropen- em resistance rates were higher. 63 imipenem-resistant pseudomonas aeruginosa metallo-β-lactamase detection rate was 38.10%（24/63）. Conclusion Metallo-β-lactamase production is one of the mechanisms for pseudomonas aeruginosa to carhapenem antibiotic resistance, the laboratory should strengthen the monitoring of enzyme production strains for clinical use of antibiotics.