K-B法检测黏液型铜绿假单胞菌不同时间药敏结果及临床意义

Drug resistance of mucoid pseudomonas aeruginosa at different time by K-B test

目的探讨黏液型铜绿假单胞菌不同时间的药敏结果差异。方法采用K-B法对黏液型铜绿假单胞菌进行药敏试验,分别检测24 h、48 h及72 h结果,并对其差异进行统计分析。结果 24 h黏液型铜绿假单胞菌对常见抗菌药物敏感率均在70%以上,其中阿米卡星、妥布霉素、庆大霉素、亚胺培南和美罗培南敏感率超过90%。48 h后黏液型铜绿假单胞菌对阿米卡星、妥布霉素、庆大霉素、亚胺培南和美罗培南敏感率均在85%～90%之间,对头孢吡肟、头孢他啶、环丙沙星和左氧氟沙星敏感率分别为60.1%、50.5%、52.0%和54.0%,对哌拉西林/他唑巴坦和氨曲南敏感率较低,分别为46.0%和41.9%。48 h药敏结果与24 h相比敏感性较低,差异均有统计学意义(P<0.05,P<0.001)。72 h与48 h药敏结果无明显差别。结论实验室尽量向临床报告48 h黏液型铜绿假单胞菌药敏结果。治疗黏液型铜绿感染时应联合大环内酯类抗生素,破坏其生物膜的影响。

Objective To investigate drug resistance difference of mucoid pseudomonas aeruginosa at different time.Methods Drug resistance of mucoid pseudomonas aeruginosa was detected by K-B method in 24 h,48 h and 72 h,then the difference was analyzed by statistics. Results The drug sensitivities of mucoid pseudomonas aeruginosa to common antibiotics in 24 h were higher than 70%,and those were more than 90% to amikacin,tobramycin,gentamicin,imipenem and meropenem,but between 85% ～ 90% in 48 h. The drug sensitivities of mucoid pseudomonas aeruginosa to cefepime,ceftazidime,ciprofloxacin and levofloxacin were 60. 1%,50. 5%,52. 0% and 54. 0% in 48 h,but lower to piperacillin-tazobactam and aztreonam,which were 46. 0% and 41. 9%,respectively. The drug sensitivities of mucoid pseudomonas aeruginosa in 48 h were lower than those in 24 h,showing statistical difference（P〈0. 05,P〈0. 001）. But there was no statistical difference between48 h and 72 h. Conclusion The drug resistance results of mucoid pseudomonas aeruginosa to antibiotics in 48 h should be reported to clinicians as far as possible. The macrolide antibiotics should be used together in treatment of pseudomonas aeruginosa infection through destroying the biofilm.