金黄杆菌临床分离株β-内酰胺酶及耐药性分析  

Analysis of beta-lactamase production and antibiotic resistance in clinically isolated Chryseobacterium spp

作　　者：林祥宏[1] 徐元宏[1] 陈晓莉[2] 朱梅[2] 凌华志[2] 李涛[2] 王中新[2] 

机构地区：[1]安徽医科大学第一附属医院检验科安徽省细菌耐药监控中心,合肥230022 [2]安徽医科大学第一附属医院检验科安徽省细菌耐药监控中心

出　　处：《临床检验杂志》2007年第5期361-363,共3页Chinese Journal of Clinical Laboratory Science

基　　金：安徽省十五攻关二期科研课题(040130583)

摘　　要：目的了解临床分离的金黄杆菌耐药特性和β-内酰胺酶产生情况。方法琼脂稀释法检测50株金黄杆菌对18种抗生素的MIC,改良的三纸片增效法和四槽、五槽三维试验法检测金黄杆菌金属β-内酰胺酶(MBL)、超广谱β-内酰胺酶(ES-BL)和AmpC酶。结果50株金黄杆菌对亚胺培南、美罗培南的耐药率为92%、88%,氨曲南为92%,阿米卡星和β-内酰胺抗生素的耐药率均大于40%,显示具有高度耐药性。加替沙星、左氧氟沙星和利福平的MIC90分别为4、8、8μg/ml,表现出很强的抗菌活性。环丙沙星、万古霉素、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦也具有良好的抗菌活性。50株金黄杆菌MBL、ES-BL、AmpC酶产酶率分别为68.0%、26.0%、0.0%。脑膜败血性金黄杆菌中产MBL73.7%,同时产MBL和ESBL42.1%,单产ESBL5.3%。产吲哚金黄杆菌MBL产酶率80.0%。结论金黄杆菌具有高度的多重耐药现象和MBL、ESBL高检出率,应该合理使用抗生素,保护易感人群,准确、及时地做好病原学诊断和耐药性监测并给予正确的治疗。Objective To investigate the antibiotic resistance and the producing rate of beta-lactamase in clinically isolated Chryseobacterium spp. Methods The MIC of 18 antibiotics to 50 strains of Chryseobacterium spp was detected by agar dilution method. The beta-lactamase （MBL, ESBL and AmpC） of Chryseobacterium spp was detected by three-disc synergy test and some modified three-dimension tests. Results The percentages of antibiotic resistance of 50 clinically isolated Chryseobacterium spp to imipenem, meropenem and aztreonam were 92% , 88% and 92% respectively, to amikacin and beta-lactamase antibiotics were also more than 40%. However, gatifloxacin, levofloxacin and rifampin showed better antimicrobiotial activity to Chryseobacterium spp compared with other antibiotics in MIC, and their MIC90 were 4, 8, 8 μg/ml respectively. Ciprofloxacin, vancomycin, cepoperazon-sulbactam and piperacillin-tazobactam showed good antimicrobiotical activity to some extent. The producing rates of MBL, ESBL and AmpC in 50 strains of Chryseobacterium spp were 68. 0% , 26.0%, and 0 respectively. The rates of MBL production in Chryseobacterium meningosepticum and Chryseobacterium indologenes were 73.7% and 80.0% respectively. In Chryseobacterium meningosepticum 42.1% produced MBL and ESBL simultaneously. Conclusions Chryseobacterium spp showed high multi-drug resistance and high production of beta-lactamase, so the treatment for it may be difficult. Antimicrobial agents should be chosen reasonably under correct directions of clinical laboratory examination.

关 键 词：金黄杆菌 三维试验 Β-内酰胺酶 耐药性 

分 类 号：R446.5[医药卫生—诊断学]