CAJ | 학술논문

目的分析医院铜绿假单胞菌的分布、耐药性及产金属β‐内酰胺酶的现状,为临床治疗铜绿假单胞菌感染提供合理用药的实验依据.方法将VITEK‐2全自动鉴定仪鉴定出的106株铜绿假单胞菌,采用琼脂纸片扩散(K‐B)法进行体外耐药性监测及统计耐药率,同时用双纸片协同试验检测金属β‐内酰胺酶的百分率.结果106株铜绿假单胞菌产金属β‐内酰胺酶的22株,占20.8%.金属β‐内酰胺酶阳性与阴性的铜绿假单胞菌耐药率相比较,对头孢他啶、头孢吡肟、亚胺培南、头孢哌酮/舒巴坦、哌拉西林、哌拉西林/他唑巴坦、头孢曲松、头孢哌酮的耐药率差异有统计学意义(P<0.05);而对氨曲南、阿米卡星、左氧氟沙星、庆大霉素呈现的耐药率二者差异无统计学意义(P>0.05).结论产金属β‐内酰胺是铜绿假单胞菌对β‐内酰胺类抗菌药物耐药的主要机制之一,临床应根据药敏结果及产酶情况综合考虑合理用药,以减少耐药菌株的产生.
목적분석의원동록가단포균적분포、내약성급산금속β‐내선알매적현상,위림상치료동록가단포균감염제공합리용약적실험의거.방법장VITEK‐2전자동감정의감정출적106주동록가단포균,채용경지지편확산(K‐B)법진행체외내약성감측급통계내약솔,동시용쌍지편협동시험검측금속β‐내선알매적백분솔.결과106주동록가단포균산금속β‐내선알매적22주,점20.8%.금속β‐내선알매양성여음성적동록가단포균내약솔상비교,대두포타정、두포필우、아알배남、두포고동/서파탄、고랍서림、고랍서림/타서파탄、두포곡송、두포고동적내약솔차이유통계학의의(P<0.05);이대안곡남、아미잡성、좌양불사성、경대매소정현적내약솔이자차이무통계학의의(P>0.05).결론산금속β‐내선알시동록가단포균대β‐내선알류항균약물내약적주요궤제지일,림상응근거약민결과급산매정황종합고필합리용약,이감소내약균주적산생.
Objective To analyze distribution ,drug resistance and situation of producing metallo‐β‐lactamase of hospital Pseudomonas aeruginosa for providing the experimental basis of the rational use of drugs for clinical treat‐ment of Pseudomonas aeruginosa infection .Methods 106 stains of P .aeruginosa were identified by VITEK‐2 auto‐matic identification system ,and ,in vitro drug resistance and statistical resistance rates were tested by K‐BETA disk diffusion method ,while the double disk synergy assay was used to test the percentage of metallo‐β‐lactamase .Results In 106 stains of Pseudomonas aeruginosa ,22 (20 .8% )of them produced metallo‐β‐lactamase .Metallo‐β‐lactamase positive strains of Pseudomonas aeruginosa had significantly higher drug resistance rates to ceftazidime (CAZ ) , cefepime(FEP ) ,imipenem (IPN ) ,cefoperazone/Sulbactam (SCF ) ,piperacillin (PIP ) ,piperacillin/tazobactam (the PIT ) ,ceftriaxone(CRO) ,cefoperazone(CFP) and than negative strains (P<0 .05) .There wa no significant difference of drug resistance rates of them to Aztreonam (AZT ) ,levofloxacin(LVF) ,gentamicin(GM ) (P>0 .05) .Conclusion Producing metallo‐β‐lactamase of Pseudomonas aeruginosa is one of the main mechanism of drug resistance to the enzyme β‐lactam antimicrobial agents ,it should be rationally use medicines in order to reduce resistance strains generating .