黏质沙雷菌的耐药率分析及碳青霉烯酶的检测  

Detection of Drug Resistance of Serratia Marcescens Rate Analysis and Carbapenemase

作　　者：王欣[1,2] 任超杰[1,2] 扈会整 郝晓柯[2] 

机构地区：[1]陕西省核工业215医院检验科,陕西咸阳712000 [2]第四军医大学西京医院检验科,西安710032

出　　处：《现代检验医学杂志》2015年第1期118-120,共3页Journal of Modern Laboratory Medicine

基　　金：陕西省科学技术研究发展计划项目（项目编号：2014K1102-03-09）.

摘　　要：目的：分析临床分离黏质沙雷菌对常规药物的耐药及产碳青霉烯酶的情况，指导临床合理用药。方法收集陕西省核工业215医院2009-2012年临床分离的106株黏质沙雷菌，K-B纸片法进行药敏试验，改良 Hodge试验筛选碳青霉烯酶，Whonet 软件统计分析。结果黏质沙雷菌在痰、分泌物、咽试子、尿液标本分别分离出89株（84.1％）、4株（3.8％）、3株（2.8％）和 3株（2.8％）。黏质沙雷菌对氨苄西林和头孢唑林的耐药率超过90％，对氨曲南、头孢吡肟、头孢他啶、哌拉西林／他唑巴坦、头孢哌酮／舒巴坦的耐药率为10％-22％，对丁胺卡那霉素、环丙沙星和亚胺培南的耐药率均低于10％；对亚胺培南耐药的菌株有4株，改良 Hodge试验阳性菌3株，阳性率为2.8％。结论黏质沙雷菌广泛耐药，其耐药机制十分复杂，该院已出现产碳青霉烯酶菌株，临床医师应根据药敏试验结果合理用药。Objective To analyze the drug resistance in clinical isolates of Serratiamarcescens of conventional treatment and carbapenemases,guiding the clinical rational drug use.Methods 106 strains of Serratiamarcescens from 2009-2012 year the clinical isolation,K-B disk diffusion susceptibility test,the modified Hodge method for screening the carbapenemase, Whonet statistical analysis.Results Serratia marcescens in sputum,secretions,swallow swab,urine samples were isolated 89 strains （84.1%）,4 strains （3.8%）,3 strains （2.8%）and 3 strains （2.8%）.Serratiamarcescens resistant to ampicillin and cefazolin rate more than 90%,to aztreonam,cefepime,ceftazidime,piperacillin/tazobactam and Cefoperazone/sulbactam, drug resistance rate was 10%-22%,to amikacin,ciprofloxacin and imipenem were lower than 10%.Imipenem the resistant strains in 4 strains,the modified Hodge test positive 3 strains,the positive rate was 2.8%.Conclusion Serratiamarcescens extensively drug-resistant strains,the resistant mechanism is very complex,the institute has appeared carbapenemase producing strains,clinicians should be based on the drug sensitivity test results.

关 键 词：黏质沙雷菌 耐药率 碳青霉烯酶 

分 类 号：R378.2[医药卫生—病原生物学] R446.5[医药卫生—基础医学]