鲍曼不动杆菌产AmpC酶的耐药性分析

Analysis of Drug-Resistance of Acinetobacter Baumannii Producing AmpC Enzyme

目的 探讨鲍曼不动杆菌分布特征及耐药性。方法 对临床分离的 14 2株鲍曼不动杆菌分布科室、感染部位及对 13种抗生素耐药性进行分析 ,并通过酶粗提物头孢西丁三维试验结合PCR法检测AmpC酶。结果 标本来源主要为患者的痰液、创口分泌物、尿液、血液等 ,科室以重症监护室为多 ,感染部位以下呼吸道为主 ,耐药性较高的抗生素为头孢噻肟、头孢曲松、氨曲南等 ,14 2株鲍曼不动杆菌中产AmpC酶菌株共 2 3株 ,产AmpC酶阳性率占总菌株数 16 2 % ,产AmpC酶菌株对各种抗生素的耐药率比不产AmpC酶的明显增高 ,治疗首选泰能。结论 鲍曼不动杆菌的多重耐药率高 。

Objective To investigate the drug-resistance and distribution of 142 strains acinetobacter baumannii.Methods Drug-resistance test of acinetobacter baumannii strains was observed in 13 kinds of antibiotics.The drug sensitivity tests was performed by the method of Kirby-Bauer paper-diffusion with the standard of NCCLS.AmpC enzyme was examined by cefoxitin three dimension test and PCR amplification of ampC structure gene were studied.Results The main sources of specimen were sputum,wound secretion,urine and blood.The respiratory tract was a major site to the development of acinetobacter baumannii.Acinetobacter baumannii strain emerged mostly in the intensive care unites.The drug resistance to cefotaxime,ceftriaxome and aztreonam were high.PCR amplification showed that of 142 acinetobacter baumannii strains,23 strains had ampC structure gene which accounted for 16 2% total strains.The drug resistance of acinetobacter baumannii producing AmpC enzyme were significantly higher than those of non-producing AmpC.The best choice of treatment was imipenem.Conclusions Acinetobacter baumannii have higher multiple-antibiotic resistance,the finding prompting us to project prospective control strategies.