气管导管细菌生物被膜的病原学分布及耐药性研究  

Pathogenic distribution and antimicrobial resistance of bacterial biofilm on endotracheal tubes

作　　者：朱娟[1] 漆涌[1] 伍勇[1] 

机构地区：[1]中南大学湘雅三医院检验科,湖南长沙410013

出　　处：《国际检验医学杂志》2010年第11期1218-1220,1223,共4页International Journal of Laboratory Medicine

基　　金：湖南省自然科学基金(08JJ3069);湖南省卫生厅科研基金(B2006-091)资助项目

摘　　要：目的研究机械通气患者气管内导管细菌生物被膜的病原学分布,探讨细菌生物被膜对抗菌药的耐药性。方法研究110例施行人工气道(气管插管和气管切开)并机械通气的患者拔除的气管内导管,用刚果红培养基筛选出生物被膜菌株和相应浮游菌株,并对生物被膜菌进行半定量检测,药敏试验分析生物被膜菌株和相应浮游菌在普通MH培养基上耐药性差异以及生物被膜阳性菌在泊洛沙姆(F-127)培养基和普通MH培养基上耐药差异进行分析。结果 110例机械通气患者气管导管中筛选出生物被膜菌61株,阳性率为55.45%。以葡萄球菌属、粪肠球菌及铜绿假单胞菌最常见,生物被膜菌与相应的浮游菌在普通MH培养基上药敏结果相似,差异无统计学意义(P>0.05);生物被膜菌在MH培养基上和在F-127培养基上药敏结果差异有统计学意义(P<0.05),且后者耐药性更强。结论该院机械通气患者气管导管生物被膜病原学分布以葡萄球菌属、粪肠球菌和铜绿假单胞菌为主,与普通MH培养基相比,F-127培养基有可能反映生物被膜菌较真实的对药物的耐受情况。Objective To study the pathogenic distribution of bacterial biofilm on endotracheal tube in mechanically ventilated patients, and to discuss the antibiotic resistance of bacterial biofilm . Methods The endotracheal tubes removed from 110 patients who were implemented artificial airway （endotracheat intubation and tracheostomy） and also ventilated mechanically were studied. The biofilm-forming bacteria strains and corresponding planktonic bacteria strains were isolated by Congo red medium, and the hiofilm bacteria strains were detected in semi-quantitative method. Antibiotic sensitivity testing was used to analyze the difference of drug resistance between the biofilm-forming bacteria strains and the corresponding planktonic bacteria on general MH medium, and the difference of antimicrobial resistance between the Biofilm-positive bacteria on Poloxamer medium（Poloxamer, F- 127） and that on general MH medium. Results In 110 mechanically ventilated patient cases, 61 hiofilm-forming isolates cultured from the endotracheal tubes （55.45%） were selected. The most common isolates included Staphylococcus, Enterococcus faecalis, and Pseudomonas aeruginosa. The antibiotic sensitivity testing results of the biofilm-forming bacteria and that of the corresponding planktonic bacteria on general MH medium were similar. The difference had no statistical significance （P〉0.05）. The antibiotic sensitivity testing results of the biofilm-forming bacteria on MH medium and that on Poloxamer medium were different. The statistical difference was significant （P〈0.05）. Moreover, the biofilm-forming bacteria were more antimicrobial resistant on Poloxamer medium. Conclusion The pathogenic distribution of bacterial biofilm on endotracheal tube in mechanically ventilated patients from our hospital was dominated by Staphylococcus, Enterococcus faecalis, and Pseudomonas aeruginosa. The difference of antibiotic resistance was not significant with the biofitm-forming bacteria and planktonic bacteria on MH medium, while the dif

关 键 词：通气机 机械 气管 导管 留置 抗药性 细菌 细菌生物被膜 

分 类 号：R378[医药卫生—病原生物学] R969.3[医药卫生—基础医学]