黏液型和非黏液型铜绿假单胞菌的分布及其对16种抗菌药物的耐药性分析

Distribution of Mucous and Non-mucous Pseudomonas Aeruginosa and Their Drug resistance Analysis in 16 Antibacterial Drugs

目的:分析黏液型和非黏液型铜绿假单胞菌(PA)的临床分布及其对16种抗菌药物的耐药性。方法:抽取2015年1月—2017年10月期间医院临床送检的从各类标本中分离出来的PA菌株205株资料,采用生物梅里埃API系统进行菌株鉴定,并采用KB纸片法进行药物敏感性试验,分析其药敏结果。结果:黏液型PA对阿米卡星、妥布霉素、黏菌素以及美洛培南抗菌药物的耐药性为0.00%,而对头孢曲松、头孢唑林以及呋喃妥因3种抗菌药物的耐药性高于66.07%,对其他抗菌药物的耐药性较低(在3.57%~21.43%之间);非黏液型PA对阿米卡星、妥布霉素及黏菌素的耐药性低于10%,而对头孢曲松、头孢唑林以及呋喃妥因的耐药性高于88.59%,对氨曲南的耐药性为51.01%,对其他抗菌药物的耐药性为12.08%~25.50%之间;除了阿米卡星、黏菌素以及妥布霉素外,非黏液型PA对其他药物的耐药率均明显高于黏液型PA(P<0.05)。结论:非黏液型PA的体外耐药性要强于黏液型PA,但由于黏液型PA分泌的藻酸盐能形成生物膜,增强其耐药性,临床使用时应根据不同类型PA的耐药性特点合理使用抗菌药物。

Objective： To distribute the mucous and non-mucous pseudomonas aeruginosa and their drug resistance analysis in 16 antibacterial drugs. Methods： From January 2015 to October 2017, 205 strains of PA strains isolated from various specimens were extracted for clinical examination in the hospital. Biological Meridier API system was used to identify the strains, and K-B disk method was used to test the drug sensitivity, and the drug sensitivity results were analyzed. Results： The drug resistance of mucinous PA to amikaine, tobramycin, myxin and meropenem was 0.00%. The drug resistance to ceftriaxone, cefazolin and furantoin was higher than 66.07%, and the drug resistance to others was between 3.57% and 21.43%. The resistance of non-mucinous PA to amikacin, tobramycin and myxomycin was lower than 10%, and the resistance to ceftriaxone, cefazolin and furantoin was over 88.59%, to aztreonam 51.01% and to other antibiotics was between 12.08% and 25.50%. With the exception of amikacin, myxin and tobramycin, the resistance rates of non-mucinous PA to other drugs were significantly higher than those of mucinous PA（P0.05）. Conclusion： The drug resistance of non-mucinous PA in vitro is stronger than that of mucinous PA. However, because alginate secreted by mucinous PA can form biofilm and enhance its resistance, antimicrobial agents should be used reasonably according to the drug resistance characteristics of different types of PA.