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张永标, 张扣兴, 温景芸, 赵锋, 刘智勇, 唐英春. 铜绿假单胞菌耐药与高活性β内酰胺酶[J]. 中国公共卫生, 2005, 21(11): 1352-1353.
引用本文: 张永标, 张扣兴, 温景芸, 赵锋, 刘智勇, 唐英春. 铜绿假单胞菌耐药与高活性β内酰胺酶[J]. 中国公共卫生, 2005, 21(11): 1352-1353.
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ZHANG Yongbiao, ZHANG Kouxing, WEN Jingyun, . Relationship between antimicrobial susceptibility and highly active β-lactamases in Pseudomonas aeruginosa[J]. Chinese Journal of Public Health, 2005, 21(11): 1352-1353.
Citation: ZHANG Yongbiao, ZHANG Kouxing, WEN Jingyun, . Relationship between antimicrobial susceptibility and highly active β-lactamases in Pseudomonas aeruginosa[J]. Chinese Journal of Public Health, 2005, 21(11): 1352-1353.
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铜绿假单胞菌耐药与高活性β内酰胺酶

Relationship between antimicrobial susceptibility and highly active β-lactamases in Pseudomonas aeruginosa

    摘要
  • 摘要:
      目的   了解铜绿假单胞菌临床分离株的耐药性及其AmpC酶、超广谱β内酰胺酶(ESBLs)和金属β内酰胺酶(MBLs)的产生情况, 指导临床合理选用抗生素.
      方法   采用K-B纸片扩散法检测药物敏感性, 通过改良酶提取物头孢西丁和头孢曲松三维试验检测AmpC酶和ESBLs, E试验MBL试条检测MBLs.
      结果   186株临床分离铜绿假单胞菌对亚胺培南的敏感率最高, 达82.3%, 对环丙沙星、哌拉西林/他唑巴坦、头孢他啶、阿米卡星、头孢哌酮/舒巴坦的敏感率依次为75.3%, 74.2%, 72.6%, 71.0%, 70.4%, 对替卡西林、头孢哌酮、氨曲南的敏感率均 < 60%, 对头孢噻肟和头孢曲松的耐药率分别为61.8%和55.9%.单产AmpC酶、同时产AmpC酶和ESBLs、单产ESBLs和单产MBLs检出率分别为8.6%(16/186), 2.7%(5/186), 14.5%(27/186), 4.8%(9/186).
      结论   临床分离铜绿假单胞菌的耐药现象不容忽视, 产生高活性β内酰胺酶是导致其耐药的机制之一, 亚胺培南仍是治疗铜绿假单胞菌感染最有效的药物.

     

    Abstract:
      Objective   To investigate the antimicrobial resistance and the prevanlence of production of AmpC β-lactamases, extended-spectrum β-lactamases(ESBLs)and metallo β-lactamases(MBLs)in Pseudomonas aeruginosa(P.aeruginosa) clinical isolates, for guiding the rational use of antibiotics.
      Methods   Antimicrobial susceptibility tests were done by Kirby-Bauer disk diffusions method, the pheno types of P.aeruginosa strains harboring AmpC β-lactamases and/or ESBLs were detected by modified three-dimensional extracttest, while MBLs were identified using MBLE-teststrips.
      Results   The suscep- tibility rate of 186 P.aeruginosa clinical isolates to imipenem was the highestabout82.3%, as to ciprofloxacin, piperacillin/tazobactam, ceftazidime, amikacin, cefoperazone/sulbactam were 75.3%, 74.2%, 72.6%, 71.0%, 70.4% respectively, but to ticarcillin, cefoperazone, aztreonam were no more than 60%.The resistantrates to cefotaxime and ceftriaxone were 61.8% and 55.9% respectively.AmpC -lactamases, Amcp β-lactamases combined with ESBLs, ESBLs and MBLs producing strains were detected in 8.6%, 2.7%, 14.5% and 4.8% of P.aeruginosa respectively.
      Conclusion   The resistantphenomenon of P.aeruginosa clinical isolates should not be ignored, production of highly active β-lactamases is one of resistantmechanisms in P.aeruginosa, imipenem is still the bestchoice for treating infection caused by P.aeruginosa.

     

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