60株铜绿假单胞菌耐药性分析及流行病学调查

Drug resistance and epidemiological investigation of 60 Pseudomonas aeruginosa strains

目的分析一段时期内60株铜绿假单胞菌(PA)的耐药性并及其DNA多态性。方法对临床分离的60株不重复铜绿假单胞菌采用Kirby-bauer(KB)法进行药敏试验,并进行随机引物多态性扩增。结果耐药率最高的是米诺环素和复方新磺胺甲恶唑,分别为100%和96.6%,其次是哌拉西林(55%),左氧氟沙星(51.6%),亚胺培南(48.3%)和美洛培南(46.6%),耐药率较低是头孢他啶(15.0%)和阿米卡星(38.3%)。各菌株基因型差别较大,在同一科室内有小范围的流行。结论 PA对多种抗菌药物耐药率均较高,仅头孢他啶与阿米卡星耐药率较低,临床可考虑选用。各菌株基因型差别较大,RAPD可以作为PA流行病学调查的手段之一。

Objective To explore the drug resistance and DNA polymorphism of 60Pseudomonas aeruginosa strains.Methods 60non-repetitive PA clinical isolates were collected from June to August and K-B method was used for the determination of drug resistance pattern.Random amplified polymorphic DNA（RAPD）analysis was used for gene typing.Results The highest resistance rates were minocycline（MH）and cotrimoxazole（SMZ）,100%and 96.6%respectively,followed by piperacillin（PIP）（55%）,levofloxacin（LEV）,imipenem（IPM）and meropenem（MEM）,55.0%,51.6%,48.3%and 46.6%respectively,yet ceftazidime（CAZ） and amikacin（AMK）marked the lowest resistance rates,15.0%and 38.3%respectively.There were significant differences in genotype in most strains and there was a small epidemics in the same ward during the period.Conclusion Most PA strains were resistant to many antibiotics and only CAZ and AMK possessed the lowest resistant rate and may be recommended for clinical treatment.RAPD analysis is a useful tool in molecular epidemiology.