ICU耐亚胺培南鲍曼不动杆菌产金属酶检测及其耐药性分析  

Detection of metalloenzyme-producing imipenem-resistant Acinetobacter baumannii from ICU and drug resistance analysis

作　　者：刘卫东 李文郎 唐恒锋 吴爱成 

机构地区：[1]深圳市观澜人民医院检验科,广东深圳518110

出　　处：《中国微生态学杂志》2013年第4期434-436,共3页Chinese Journal of Microecology

摘　　要：目的了解重症监护病房(ICU)耐亚胺培南鲍曼不动杆菌(IRABA)的金属β-内酰胺酶(MBLs)的产生情况及其耐药特性,为临床抗感染治疗提供依据。方法对深圳市观澜人民医院2010年1月至2012年6月ICU分离的487株鲍曼不动杆菌(ABA),用双纸片协同试验检测MBLs产生情况,用VITEK 2 compact全自动微生物分析系统检测其对18种抗生素的耐药性。结果在487株ABA中检出IRABA 320株(65.7%);IRABA对其中7种抗生素为全耐药,对其中10种抗生素的耐药率在80%以上;比较IRABA与ISABA(亚胺培南敏感鲍曼不动杆菌)两组对常用抗生素的耐药率,除CZO、FTN、及CTT外,两组对其余抗生素的耐药率差异均有统计学意义(P<0.01);在320株IRABA中,检出产MBLs 145株,产酶率为45.3%。结论 IRABA的检出率较高,多药耐药现象较严重,产MBLs是ABA对IPM及头孢类抗菌药物耐药的主要原因之一,应参考实验室的药敏结果,合理选用抗菌药物。Objective To understand the metallo-beta-lactamase(MBL) production by and the resistance of imipenem-resistant Acinetobacter baumannii(IRABA) from ICU in order to provide evidences for clinical anti-infection treatment.Methods 487 strains of Acinetobacter baumannii(ABA) isolated from the ICUs of the hospital from 2010 January to 2012 June were detected with double disk synergy test for the production of MBLs.VITEK 2 compact automatic microbiology analysis system was used to detect their resistance to 18 antibiotics.Results In the 487 strains of ABA,320 strains(65.7%) of IRABA were detected,which showed a resistance rate of 100% to 7 antibiotics,and the resistance rates to the remaining 10 antibiotics were above 80%.The resistance rates of IRABAs and imipenem-susceptible Acinetobacter baumannii(ISABAs) to most of the antibiotics(except cephazolin,furantoin and cephotetan) had statistically significant difference(P<0.01).In the 320 strains of IRABA,145 strains(45.3%) were found to produce MBLs.Conclusion The detection rate of IRABAs is high with severe multidrug resistance.MBLs production is the main reason of the resistance of ABAs to imipenem,Susceptibility test results should consulted to choose antibacterial drugs reasonablly.

关 键 词：重症监护病房 亚胺培南 鲍曼不动杆菌 金属Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]