脑膜脓毒金黄杆菌的耐药性比较  

Drug Resistance of Chryseobacterium meningosepticum

作　　者：王冬国[1] 张瑾[1] 王红戟[2] 俞莲花[1] 徐昌君[1] 

机构地区：[1]台州市立医院,浙江台州318000 [2]台州市路桥区疾病预防控制中心,浙江台州318050

出　　处：《中华医院感染学杂志》2007年第6期740-742,共3页Chinese Journal of Nosocomiology

摘　　要：目的比较与分析ICU与非ICU患者产金属β-内酰胺酶(MBL)、ESBLs的脑膜脓毒金黄杆菌的耐药性的异同,以指导临床正确合理选用抗菌药物。方法用VITEK-32鉴定菌株;双纸片协同试验筛选产MBL菌株;双纸片协同试验筛选产超广谱β-内酰胺酶(ESBLs)菌株;药敏试验使用VITEK GNS 143上机检测和K-B法检测加做的药敏试验。结果ICU患者脑膜脓毒金黄杆菌产MBL为49.0%,远高于非ICU患者的13.8%;ICU患者脑膜脓毒金黄杆菌产ESBLs为37.2%与非ICU患者的30.8%相比,差异无统计学意义;ICU患者脑膜脓毒金黄杆菌对氨苄西林/舒巴坦、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢吡肟、环丙沙星、左氧氟沙星6种抗菌药物的耐药率远比非ICU患者的高。结论脑膜脓毒金黄杆菌高耐药性的根本原因是高产酶率(产MBL和ESBLs)。OBJECTIVE To compare and analyze the drug resistance of Chryseobacteriurn rneningosepticurn which producing metallo-β-1actamase（MBL） and extended-spectrum-β-1actamases （ESBLs） from ICU patientsr and non ICU patientsr specimens of sputa so as to guide the rational application of antibiotics. METHODS Identified the strains with VITEK 32, MBL and ESBLs were also screened by double disk synergy;the antimicrobial sensitivity of clinical isolates was tested by VITEK GNS143 and the antimicrobial sensitivity was added and tested by K-B method. RESULTS As a result the rate of producing MBL of C. rnenlngosepticum was 49.0N from ICU patients＇ specimens of sputa which was higher than the rate of 13.8% from non ICU patients＇ ;the rate of producing ESBLs of C. meningosepticurn was 37. 2% from ICU patients＇ specimens of sputa which was higher than the rate of 30.6% from non ICU patients r; the rate of drug resistance to AMP/SUB, TZP, CEP, CIP, and LEV from ICU patientsr was higher than that from non ICU patients. CONCLUSIONS Why the high resistance rate of C. rnengingosepticurn in ICU patientsr specimens of sputa might be due to the high producing β-1actamases （MBL and ESBLs）.

关 键 词：ICU患者 非ICU患者 脑膜脓毒金黄杆菌 MBL ESBLs耐药率 

分 类 号：R373.31[医药卫生—病原生物学]