临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
1期
60-62
,共3页
鲍曼不动杆菌%阿米卡星%K-B法药敏%双圈耐药
鮑曼不動桿菌%阿米卡星%K-B法藥敏%雙圈耐藥
포만불동간균%아미잡성%K-B법약민%쌍권내약
Acinetobacter baumannii%Amikacin%K - B susceptibility testing%Double - circle resistance
目的：调查鲍曼不动杆菌（Ab）K - B 法药敏试验阿米卡星出现的双圈现象，结合不同药敏试验方法和药敏结果探讨其治疗选药。方法全部37株非重复 Ab 均用 VITEK -2 compact 全自动微生物鉴定仪鉴定并做仪器法药敏；通过 K - B 法再对阿米卡星单独做纸片法药敏试验，并对出现双圈现象的鲍曼不动杆菌进行传代诱导；琼脂稀释法检测阿米卡星对出现双圈和耐药现象的菌株最低抑菌浓度（MIC）。结果全部37株 Ab 被 VITEK -2 compact 全自动微生物鉴定仪确认并报告为对阿米卡星敏感；K - B 法21株阿米卡星周围显示双圈表型、12株敏感、4株耐药；诱导7 h左右开始出现双圈现象，至第6代抑菌圈完全消失；琼脂稀释法得出出现双圈和耐药现象的菌株 MIC 值≥4096 mg/ L，个别菌株高达8192 mg/ L，均达到耐药标准。结论仪器法药敏缺乏药物选择灵活性，应仔细阅读操作说明，药敏试验结果应参考 K - B 法并进行修正，以免误导临床；阿米卡星 K - B 法产生双圈现象应报告阿米卡星耐药；双圈现象可经传代诱导消失。
目的：調查鮑曼不動桿菌（Ab）K - B 法藥敏試驗阿米卡星齣現的雙圈現象，結閤不同藥敏試驗方法和藥敏結果探討其治療選藥。方法全部37株非重複 Ab 均用 VITEK -2 compact 全自動微生物鑒定儀鑒定併做儀器法藥敏；通過 K - B 法再對阿米卡星單獨做紙片法藥敏試驗，併對齣現雙圈現象的鮑曼不動桿菌進行傳代誘導；瓊脂稀釋法檢測阿米卡星對齣現雙圈和耐藥現象的菌株最低抑菌濃度（MIC）。結果全部37株 Ab 被 VITEK -2 compact 全自動微生物鑒定儀確認併報告為對阿米卡星敏感；K - B 法21株阿米卡星週圍顯示雙圈錶型、12株敏感、4株耐藥；誘導7 h左右開始齣現雙圈現象，至第6代抑菌圈完全消失；瓊脂稀釋法得齣齣現雙圈和耐藥現象的菌株 MIC 值≥4096 mg/ L，箇彆菌株高達8192 mg/ L，均達到耐藥標準。結論儀器法藥敏缺乏藥物選擇靈活性，應仔細閱讀操作說明，藥敏試驗結果應參攷 K - B 法併進行脩正，以免誤導臨床；阿米卡星 K - B 法產生雙圈現象應報告阿米卡星耐藥；雙圈現象可經傳代誘導消失。
목적：조사포만불동간균（Ab）K - B 법약민시험아미잡성출현적쌍권현상，결합불동약민시험방법화약민결과탐토기치료선약。방법전부37주비중복 Ab 균용 VITEK -2 compact 전자동미생물감정의감정병주의기법약민；통과 K - B 법재대아미잡성단독주지편법약민시험，병대출현쌍권현상적포만불동간균진행전대유도；경지희석법검측아미잡성대출현쌍권화내약현상적균주최저억균농도（MIC）。결과전부37주 Ab 피 VITEK -2 compact 전자동미생물감정의학인병보고위대아미잡성민감；K - B 법21주아미잡성주위현시쌍권표형、12주민감、4주내약；유도7 h좌우개시출현쌍권현상，지제6대억균권완전소실；경지희석법득출출현쌍권화내약현상적균주 MIC 치≥4096 mg/ L，개별균주고체8192 mg/ L，균체도내약표준。결론의기법약민결핍약물선택령활성，응자세열독조작설명，약민시험결과응삼고 K - B 법병진행수정，이면오도림상；아미잡성 K - B 법산생쌍권현상응보고아미잡성내약；쌍권현상가경전대유도소실。
Objective To investigate the phenomenon of double - circle resistance in K - B susceptibility testing of Acinetobacter bau-mannii(A. baumannii)to amikacin. Methods VITEK2 - compact system was used to identify A. baumannii,and analyze their susceptibility to antibiotics. The 37 A. baumannii isolates were also screened by K - B susceptibility testing to detect susceptibility to amikacin. MICs of the ami-kacin for the isolates which were double - circle resistant were determined by agar dilution method. Results The 37 isolates were confirmed and sensitive to amikacin by VITEK2 - compact system. However,the susceptibility to amikacin by K - B susceptibility testing was quite different from VITEK2 - compact system. MICs of the amikacin suggested that the A. baumannii double - circle resistance to amikacin should be reported as re-sistant A. baumannii,that was consistent to the result emerged from K - B susceptibility testing. Conclusion The drug susceptibility results ob-tained from VITEK2 - compact system should be adjusted according to K - B susceptibility testing results. A. baumannii double - circle resistance to amikacin should be reported as amikacin resistant.
