鲍曼不动杆菌高活性β-内酰胺酶检测与耐药性变迁  

Detection of highly active β-lactamases and changes of antimicrobial resistance in Acinetobacter baumannii

作　　者：张永标[1] 张扣兴[2] 赵锋 杨晓燕[1] 席云[3] 文博[3] 唐英春[2] 

机构地区：[1]中山大学附属第三医院急诊科,广东广州510630 [2]中山大学附属第三医院呼吸科,广东广州510630 [3]中山大学附属第三医院检验科,广东广州510630

出　　处：《中国微生态学杂志》2005年第6期460-461,共2页Chinese Journal of Microecology

摘　　要：目的了解中山大学附属第三医院鲍曼不动杆菌临床分离株Am pC酶、超广谱β-内酰酶(ESBL s)和金属β-内酰胺酶(M BL s)的产生情况及其耐药性。方法采用M icroscanW a lkAw ay-40全自动微生物鉴定仪及配套阴性菌药敏复合板进行菌种鉴定与药敏试验,改良酶提取物头孢西丁和头孢曲松三维试验检测Am pC酶和ESBL s,E试验M BL试条检测M BL s。结果Am pC酶和ESBL s产酶株总检出率为26.8%(57/213),未检出产M BL s株。药敏结果提示对亚胺培南敏感率最高,其次是氨苄西林-舒巴坦、头孢吡肟、哌拉西林-他唑巴坦。结论鲍曼不动杆菌耐药性高,产生高活性β-内酰胺酶是介导其耐药的机制之一,亚胺培南仍是治疗该菌感染最为有效的药物。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 Acinetobacter baumannii clinical isolates. Methods Bacterial confirmatory and antibiotic susceptibility tests were carried out by American Dade Behring Company Microscan WalkAway-40 system and Negative Combo Panel Type 21 ,the phenotypes of Acinetobacter baumannii strains harboring AmpC β-lactamases and/or ESBLs were detected by modified three-dimensional extract test,while MBLs were identified using MBL E-test strips. Results AmpC β-lactamases and ESBLs producing strains were detected in 26.8% of 213 clinical isolates,MBLs producing strains were not found. The overall susceptibility rate of Acinetobacter baumannii to imipenem was the highest, followed by ampicillin-sulbactam, cefepime,piperacillin-tazobactam. Conclusion The resistance of Acinetobacter baumannii clinical isolates was high,production of highly active β-lactamases was one of resistant mechanisms in them,imipenem was still the best choice for treating infection caused by Acinetobacter baumannii.

关 键 词：鲍曼不动杆菌 Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]