CAJ | 학술논문

目的：检测ICU患者标本分离铜绿假单胞菌（ PA）产金属β－内酰胺酶（ MBL）情况，分析PA对抗菌药物耐药性机制，比较和评价不同表型检测方法。方法本研究为前瞻性研究，实验检测520例ICU患者标本，分离PA是否产生金属MBL。通过全自动微生物鉴定系统鉴定PA，共147株PA从ICU患者分离出来。并进一步通过亚胺培南－EDTA联合法和亚胺培南－EDTA双纸片协同法检测MBL。结果147株PA中有33株（22．4％）对亚胺培南有耐药性。亚胺培南－EDTA联合法检测对亚胺培南耐药的PA菌株MBL为阳性；然而，亚胺培南－EDTA双纸片协同法检测只有24株PA菌株MBL阳性。结论 MBL是33株PA对碳青霉烯类抗菌药物耐药的主要机制，MBL的产生与ICU患者多耐药性密切相关。
목적：검측ICU환자표본분리동록가단포균（ PA）산금속β－내선알매（ MBL）정황，분석PA대항균약물내약성궤제，비교화평개불동표형검측방법。방법본연구위전첨성연구，실험검측520례ICU환자표본，분리PA시부산생금속MBL。통과전자동미생물감정계통감정PA，공147주PA종ICU환자분리출래。병진일보통과아알배남－EDTA연합법화아알배남－EDTA쌍지편협동법검측MBL。결과147주PA중유33주（22．4％）대아알배남유내약성。아알배남－EDTA연합법검측대아알배남내약적PA균주MBL위양성；연이，아알배남－EDTA쌍지편협동법검측지유24주PA균주MBL양성。결론 MBL시33주PA대탄청매희류항균약물내약적주요궤제，MBL적산생여ICU환자다내약성밀절상관。
Objective To detect Metallo-beta-lactamase ( MBL) producing aeruginosa( PA) isolates from ICU patients, to analysis of mechanism of antibiotic resistance of PA to compare and evaluate different phenotypic methods currently in use and to determine antibiograms.Methods A prospective study was undertaken to detect MBL in PA isolates obtained from 520 ICU samples.A total of 147 strains were recovered from patients admitted in ICU, and screened for imipenem resistance by automatic bacteria identification system.Detection of MBL was further done by imipenem-EDTA disk synergy test and combined disk test.Results Out of 147 isolates, 33 isolates (22.4%) were imipenem resistant.All 33 imipenem resistant PA strains, when further tested, were positive for MBL production by combined disk test, but only 24 showed positive results by imipenem -EDTA disk synergy test. Conclusion MBL production was the main resistance mechanism in the 33 carbapenem resistant PA isolates collected, with multidrug resistance associating significantly with MBL production in PA from ICU.