184株铜绿假单胞菌的耐药性分析

THE ANALYSIS OF DRUG-RESITANCE OF 184 STRAINS PSEUDOMONASE AERUGINOSA

目的 :研究铜绿假单胞菌的耐药性 ,以指导临床合理用药。方法 :对 184株铜绿假单胞菌选用 16种常用抗生素进行药敏试验。药敏试验采用 WHO推荐的 Kirby— Bauer纸片扩散法按 NCCL S标准进行 ,同时对 184株铜绿假单胞菌进行诱导型 β-内酰胺酶的检测。结果 :184株铜绿假单胞菌中检出诱导酶 115株 ,占 6 2 .2 %。所有菌株无一例对全部抗生素敏感。亚胺培南、氨曲南、庆大霉素、阿米卡星、环丙沙星、诺氟沙星、哌拉西林、头孢哌酮、头孢他啶对铜绿假单胞菌的抗菌活性较强 ,敏感率为 76 .1%～ 92 .9% ,而三代头孢中的头孢噻肟和头孢曲松的敏感率仅为 8.7%和 12 .0 %。诱导酶株组对三代头孢中的头孢哌酮、头孢他啶的耐药率比非产酶株组低 ,尤其头孢他啶的耐药率比非产酶株组明显降低 ,仅为 3.4% ;亚胺培南和派拉西林的耐药率也比非产酶株组低 ,耐药率分别为 6 .5 %和 5 .1%。结论 :对于产诱导型 β-内酰胺酶的铜绿假单胞菌株应选用亚胺培南、氟喹诺酮类及氨基糖甙类抗生素 ,常规的体外药敏试验不能完全正确的反映细菌的耐药性。通过诱导酶的检测 。

Objective:To study the drug resitance of 184 strains pseudomonase aeruginosa, and to guide the reasonable use of antibiotics in clinic Methods:Drug resitance test to 184 strains pseudomonase aeruginosa was performed, by using of 16 kinds of ordinary antibiotics The test exaimeed inductive type β lactamase in 184 strains pseudomonase aeruginosa, with the method of kirby Bauer paper diffurion (which was recommended by WHO)and with the standard of NCCLS Results: 115 strains inductive enryme was selected from 184, account for 62 2% No one strain was sensitive to all the antibiotics The antibiotics activity of imipenem? aztreonam? gentamycin?amikacin?ciprofloxain?norfloxain?piperacillin?ceoperazone?ceftazidime(sensibility is 76 1%～92 9%)was stronger than cefotaxime and ceftriaxoe in the third generation cephalosporins, with the sensibility of 8 7% and 12 0%seperately The drug gesistance to ceoperazone?ceftazidime in strains of inductive enryme was lower than that of non enryme produce group,especially ceftazidime the drug gesistance of it was 3 4%, that of imipenem and piperacillin was 6 5% and 5 1%% seperately Conclusion:We should select imipenem? fluoroquinolones and aminoglycoside antibiotics to strains which produce inductivetype β lactamase The drug resistance cann't be reflected correctly through regular in vitro drug sensitivity test The examination of inductive enryme can make up the insuf fcience of drug sensitivity test