持续性肺部感染铜绿假单胞菌的耐药机制

Drug resistant mechanism of Pseudomonas aeruginosaleading to persistent pulmonary infections

目的探讨临床引起持续性肺部感染的铜绿假单胞菌(PAE)耐药机制。方法通过对临床分离的PAE在体外诱导形成生物被膜能力和其在体外的药物敏感性,探讨PAE在临床引起持续性感染的耐药机制。结果在临床引起持续性感染PAE的生物被膜生成能力显著高于非持续性感染的PAE,在临床引起持续性和非持续性感染的PAE在体外药敏试验中均具有比较高的耐药性,虽然二者耐药率差异无统计学意义,但在临床引起持续性感染的PAE对部分抗菌药物的耐药性,如哌拉西林、替卡西林/克拉维酸、头孢他啶、头孢曲松、头孢噻肟、头孢吡肟、氨曲南等有高于引起非持续性感染PAE的趋势。结论 PAE强的生物膜生成能力和其浮游菌比较高的耐药性趋势,是PAE在临床引起持续性感染的重要机制。

OBJECTIVE To study the mechanism leading to the persistent pulmonary infections caused by Pseudomonas aeruginosa.METHODS The mechanism of P.aeruginosa that leads to the persistent pulmonary infections was explored by analyzing the ability of forming biofilm under in vitro induction and the in vitro drug susceptibility testing.RESULTS The ability of forming biofilm by P.aeruginosa causing persistent pulmonary infections was stronger than that causing non-persistent pulmonary infections,the in vitro drug susceptibility testing showed that the drug resistance rate of P.aeruginosa causing persistent infections and non-persistent infections was relatively high,the difference in the drug resistance was not statistically significant,the drug resistance rates of P.aeruginosa causing persistent infections to piperacillin,ticarcillin/clavulanic acid,ceftaczidime,ceftriaxone,cefotaxime,cefepime,and aztreonam were higher than those of P.aeruginosa causing non-persistent infections.CONCLUSION The strong ability of forming biofilm and the high drug resistance of planktonic P.aeruginosa are the important mechanisms that leads to persistent infections caused by P.aeruginosa.