烧伤感染铜绿假单胞菌对β-内酰胺类药物的耐药分析

Analysis of the resistance to 16 β-lactam antibiotics of 760 pseudomonas aeruginosa of pathogens isolated from burn infection

目的 对我院 1993年 1月～ 1999年 11月铜绿假单胞菌 760株对 16种 β 内酰胺类抗生素的耐药性予以分析 ,为临床合理应用抗生素有效治疗由铜绿假单胞菌引起的感染提供实验室依据。方法 利用VITEK AMS鉴定所有菌株 ,鉴定标准化百分率均在 95 %以上。药敏实验给出相应的MIC值。结果 1993年 1月～ 1999年 11月铜绿假单胞菌平均检出率为 3 0 % ,为各种细菌分离率之首。在G-菌中 7年检出率分别为 5 5 %、66%、5 0 %、5 3 %、3 8%、49%和 40 %。一、二代头孢菌素连续 7年的耐药率均为 95 %以上 ,羧基类青霉素 (替卡西林 ) ,7年监测结果敏感性不超过 2 0 %。三代头孢菌素中头孢他啶、头孢哌酮敏感性分别为 60 .5 %、62 .6% ;亚胺培南、氨曲南敏感性分别为 5 5 .3 %、5 9.3 %。结论 烧伤病人感染G-菌中铜绿假单胞菌占有相当大的比重 ;建议三代头孢菌素应作为治疗铜绿假单胞菌首选药物。我院铜绿假单胞菌所产生的 β 内酰胺酶主要是由染色体所介导。

Objective To study the resistance characteristics of pseudomonas aeruginosa of burn infection.In this work,we reported the resistance to 16 β lactam antibiotics of 760 clinical isolates of pseudomonas aeruginosa collected from burn infection during the period from the 1993.1 to 1999.11.Methods All strains were assayed using VITEK AMS and the percentage of standard identification was above 95.Drug sensibility test showed the corresponding MIC.Results The result showed 30% of bacteria was pseudomonas aeruginosa and 55%,66%,50%,53%,38%,49% and 40% of pseudomonas aeruginosa were respectively isolated from gram negative bacilli during 1993.1～1999.11.Resistance rates of pseudomonas aeruginosa to the first and the second generation cephalosporins were over 95%.Pseudomonas aeruginosa were lowly sensitive to carboxypenieillins(Ticarcillin),with a sensitive rate of less than 20%,but the third generation cephalosporins and other β lactam were sensitive,the sensibility rates of ceftazidime,cefoperazone,imipenem and aztreoname being 60.5%,55.3% and 59.3% respectively.Conclusion Pseudomonas aeruginosa were the main microorganisms of burn infection.We suggest the third generation cephalosporins be the first choice of antibiotics for burn with pseudomonas aeruginosa infection.β lactamase of the pseudomonas seruginosa were most encoded by the chromosomes.