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作 者:王赤华[1] 曾勇[2] WANG Chi-hua ZENG Yong(Huanggang Center for Disease Control and Prevention, Huanggang, Hubei 438000 Huanggang City Hospital of Traditional Chinese Medicine, Huanggang, Hubei 438000,China)
机构地区:[1]湖北省黄冈市疾病预防控制中心,湖北黄冈438000 [2]湖北省黄冈市中医医院,湖北黄冈438000
出 处:《热带医学杂志》2016年第11期1362-1363,1378,共3页Journal of Tropical Medicine
基 金:湖北省自然科学基金计划项目(EK2014D210006000852)
摘 要:目的了解鲍曼不动杆菌院内感染株的产酶现状与耐药水平,为临床治疗与院感监控提供参考。方法按临床检验操作规程进行菌株分离鉴定,以Nitrocefin法检测β-内酰胺酶,用三维试验与K-B法进行酶型分析与药敏试验。结果临床分离175株鲍曼不动杆菌,82.28%来自呼吸道。产β-内酰胺酶124株,阳性率70.9%,其中,产超广谱β-内酰胺酶(ESBL)52株(41.9%),产头孢菌素酶(Am PC酶)70株(56.4%),产金属β-内酰胺酶(MBL)2株(1.6%)。本组菌株对常用抗菌药物广泛耐药,对头孢哌酮/舒巴坦(SCF)耐药率为37.7%,亚胺培南耐药率为1.1%(仅2株MBL耐药)。结论呼吸道是鲍曼不动杆菌院内感染主要途径;超广谱β-内酰胺酶与Am PC酶,是鲍曼不动杆菌主要耐药机制;减少耐碳青霉烯类肠杆菌感染是抗击耐药菌主要策略。Objective To investigate the current situation of enzyme production and drug resistance of nosocomial infection strains of Acinetobacter baumannii , and provide reference for clinical treatment and monitoring of hospital infection. Methods Bacteria strains were isolated and identified according to the clinical laboratory procedures. The Nitrocefin method was used to detect the beta-lactamase. Results 175 strains of Acinetobacter baumannii were isolated, 82.28% from the respiratory tract. 124 strains could produce beta-lactamase, with a positive rate of 70.9%. Among them, 52 strains (41.9%) produce extended spectrum beta-lactamase (ESBL); 70 stains (56.4%) produced AmPC enzyme; 2 strains (1.6%) produced metallo-beta-lactamase sand. The isolates were resistant to commonly using drugs. 37.7% was resistant to Cefoperazone/sulbactam (SCF), 1.1% to imipenem (only two strains of MBL resistance). Conclusions Respiratory tract was the main route of nosocomial infection of Acinetobacter baumannii; ESBL and AmPC production could be the main resistance mechanism of Acinetobacter baumannii.To reduce carbapenem-resistant Enterobacteriaceae infection should be the main strategy to combat drug-resistant bacteria.
分 类 号:R378.2[医药卫生—病原生物学]
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