中国实验诊断学
中國實驗診斷學
중국실험진단학
CHINESE JOURNAL OF LABORATORY DIAGNOSIS
2014年
6期
978-981
,共4页
铜绿假单胞菌%超广谱β-内酰胺酶%AmpC酶%耐药性
銅綠假單胞菌%超廣譜β-內酰胺酶%AmpC酶%耐藥性
동록가단포균%초엄보β-내선알매%AmpC매%내약성
Pseudomonas aeruginosa%β-lactamases%AmpCβ-lactamases%Antimicrobial resistance
目的：了解我院2012年铜绿假单胞菌超广谱β-内酰胺酶（ESBLs）和头孢菌素酶（AmpC 酶）在感染中的流行情况及耐药特征，为临床合理使用抗生素提供实验室依据。方法细菌鉴定采用法国生物梅里埃公司 VITEK2-compact 的 GN 鉴定卡；药敏试验采用 K-B 扩散法；双纸片增效法检测 ESBLs；头孢西丁三维实验法检测 AmpC 酶；应用 Whonet5．4、SPSS13．0软件进行统计分析。结果在2113份阳性标本中分离出铜绿假单胞菌314株为14．9％，其中呼吸道标本的阳性率最高为78．0％，以呼吸内科、老年病科及 ICU 病房检出率为主，分别为22．6％、19．4％、18.5％。单产 AmpC 酶、单产 ESBLs 及同时产 AmpC 酶＋ESBLs 的铜绿假单胞菌分别为81株、56株、56株，其中ICU 产酶率最高，其次为呼吸内科及老年病科，产酶率分别占79．3％、71．8％、70．5％。铜绿假单胞菌对美罗培南，阿米卡星及亚胺培南耐药性最低，分别为15．3％、19．7％、25．8％。结论产酶的铜绿假单胞菌多药耐药严重，合理使用抗生素以减少耐药率。
目的：瞭解我院2012年銅綠假單胞菌超廣譜β-內酰胺酶（ESBLs）和頭孢菌素酶（AmpC 酶）在感染中的流行情況及耐藥特徵，為臨床閤理使用抗生素提供實驗室依據。方法細菌鑒定採用法國生物梅裏埃公司 VITEK2-compact 的 GN 鑒定卡；藥敏試驗採用 K-B 擴散法；雙紙片增效法檢測 ESBLs；頭孢西丁三維實驗法檢測 AmpC 酶；應用 Whonet5．4、SPSS13．0軟件進行統計分析。結果在2113份暘性標本中分離齣銅綠假單胞菌314株為14．9％，其中呼吸道標本的暘性率最高為78．0％，以呼吸內科、老年病科及 ICU 病房檢齣率為主，分彆為22．6％、19．4％、18.5％。單產 AmpC 酶、單產 ESBLs 及同時產 AmpC 酶＋ESBLs 的銅綠假單胞菌分彆為81株、56株、56株，其中ICU 產酶率最高，其次為呼吸內科及老年病科，產酶率分彆佔79．3％、71．8％、70．5％。銅綠假單胞菌對美囉培南，阿米卡星及亞胺培南耐藥性最低，分彆為15．3％、19．7％、25．8％。結論產酶的銅綠假單胞菌多藥耐藥嚴重，閤理使用抗生素以減少耐藥率。
목적：료해아원2012년동록가단포균초엄보β-내선알매（ESBLs）화두포균소매（AmpC 매）재감염중적류행정황급내약특정，위림상합리사용항생소제공실험실의거。방법세균감정채용법국생물매리애공사 VITEK2-compact 적 GN 감정잡；약민시험채용 K-B 확산법；쌍지편증효법검측 ESBLs；두포서정삼유실험법검측 AmpC 매；응용 Whonet5．4、SPSS13．0연건진행통계분석。결과재2113빈양성표본중분리출동록가단포균314주위14．9％，기중호흡도표본적양성솔최고위78．0％，이호흡내과、노년병과급 ICU 병방검출솔위주，분별위22．6％、19．4％、18.5％。단산 AmpC 매、단산 ESBLs 급동시산 AmpC 매＋ESBLs 적동록가단포균분별위81주、56주、56주，기중ICU 산매솔최고，기차위호흡내과급노년병과，산매솔분별점79．3％、71．8％、70．5％。동록가단포균대미라배남，아미잡성급아알배남내약성최저，분별위15．3％、19．7％、25．8％。결론산매적동록가단포균다약내약엄중，합리사용항생소이감소내약솔。
Objective To investigate the prevalence of strains producing extended-spectrum β-lactamases (ESBLs) and AmpCβ-lactamases in Pseudomonas aeruginosa in our hospital from 2012,and to supply the laboratory evidence for antibiotic rational application in clinic.Methods The bacterial identification was performed by using the GN identifica-tion card of VITEK2-Compact automatic instrument from French Bio-Merieux.Kirby-Bauer method was employed to carry out the antimicrobial susceptibility testing.ESBLs were detected by synergistic test,and cefoxitin three dimen-sional test was applied to filter AmpC positive strains.The statistical analysis was performed with Whonet 5.4 and SPSS 13.0 softwares.Results A total of 314 strains of Pseudomonas aeruginosa were isolated from 2113 positive sam-ples,with the detection rate of 14.9%.Among them respiratory specimen has the highest positive rate was 78.0%.The detection rate of the strains was 22.6% in the deparment of respiratory medicine,19.4% in the department of geriat-rics,and 12.0% in ICU.Among 314 strains of Pseudomonas aeruginosa,81 strains were AmpC enzymes positive,56 strains were ESBLs positive,and 56 were AmpC+ESBLs.The ICU enzyme production rate is the highest,followed by breaching internal medicine and geriatrics,enzyme production rate accounted for 79.3%,71.8% and 70.5%,respective-ly.The drug resistance rates of the Pseudomonas aeruginosa strains to meropenem,amikacin,And imipenem were 15.3%,19.7%,and25.8%,respectively.Conclusions Enzyme production of Pseudomonas aeruginosa is serious,rea-sonable use of antibiotic to reduce resistance.
