多药耐药鲍氏不动杆菌与铜绿假单胞菌对头孢哌酮/舒巴坦的敏感性研究  

Susceptibility to Cefoperazone/sulbactam of Multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa

作　　者：黄义山[1] 方莉[1] 苏中龙[1] 朱兴春[1] 林芳[1] 何英[1] 霍亚平[1] 

机构地区：[1]川北医学院附属医院检验科,四川南充637000

出　　处：《中华医院感染学杂志》2010年第4期548-551,共4页Chinese Journal of Nosocomiology

摘　　要：目的比较多药耐药鲍氏不动杆菌与多药耐药铜绿假单胞菌产金属β-内酰胺酶的情况和对头孢哌酮/舒巴坦的耐药性,为临床治疗该细菌感染提供实验室依据。方法用VITEK-32、GNS-132系统常规检测非重复鲍氏不动杆菌42株、铜绿假单胞菌95株,同时用Etest检测金属β-内酰胺酶,用纸片扩散法(K-B法)检测头孢哌酮/舒巴坦和多黏菌素E的药敏试验,分析二者不同耐药表型对头孢哌酮/舒巴坦的敏感性差异。结果鲍氏不动杆菌、铜绿假单胞菌对亚胺培南耐药率分别为66.7%、31.6%;多药耐药鲍氏不动杆菌、铜绿假单胞菌均有较多产金属β-内酰胺酶株;头孢哌酮/舒巴坦耐对亚胺培南非产金属β-内酰胺酶的敏感性差异无统计学意义,头孢哌酮/舒巴坦对耐亚胺培南产金属β-内酰胺酶的敏感性差异有统计学意义(P<0.05)。结论多药耐药鲍氏不动杆菌对头孢哌酮/舒巴坦敏感性高于多药耐药铜绿假单胞菌,治疗耐亚胺培南的多药耐药鲍氏不动杆菌可选用头孢哌酮/舒巴坦,治疗耐亚胺培南的多药耐药铜绿假单胞菌特别是MBLs应选用多黏菌素E或联合用药。OBJECTIVE To detect metallo-β-lactamases（MBLs） produced by multidrug-resistant Acinetobacterbaumannii （MDR-AB） and multidrug resistant Pseudomonas aeruginosa （MDR-PA） in our hospital and their resistance to cefoperazone/sulbactam. METHODS VITEK-32, GNS-132 system, routine test were used to detect non-duplicating A. baumannii（42 strains） and P. aeruginosa （95 strains）, while Etest used to detect MBLs and K-B method to detect drug sensitivity to cefoperazone/sulbactam and polymyxin E. The sensitivity of two different drug-resistant phenotypes to cefoperazone/sulbactam was and analyzed. RESULTS The imipenem resistance rate of A. baumannii and P. aeruginosa was 66.7% and 31.6%, respectively. MRD-AB and MRD-PA had more MBLs strains. The sensitivity of imipenem-resistant van-producing MBLs strains to cefoperazone/sulbactam statistically was without significant difference, while that with MBLs was with significant difference （P 〈 0. 05）. CONCLUSIONS The sensitivity to cefoperazone/sulbactam of MDR-AB is higher than that of MDR-PA. Cefoperazone/sulbactam can be choose to treat MDR-AB with imipenem resistance MDR-PA with imipenem resistance especially producing metallo β-lactamases, can be treated with polymyxin E or its combination.

关 键 词：头孢哌酮/舒巴坦 铜绿假单胞菌 鲍氏不动杆菌 金属Β-内酰胺酶 耐药 

分 类 号：R978.1[医药卫生—药品]