铜绿假单胞菌D-试验阳性及阴性菌株产β-内酰胺酶的差异性分析  

Study on the Difference of β-Lactamases-Producing in D-Test Positive and D-Test Negative Pseudomonas Aeruginosa

作　　者：谢国艳[1] 肖敏[2] XIE Guo-yan;XIAO Min(Department of Clinical Laboratory,Chongming Branch of Xinhua Hospital ,Shanghai J iaotong University School of Medicine ,Shanghai 202150 ,China;Department of Clinical Laboratory, the 306th Hospital of PLA ,Beijing 100101, China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院检验科,上海202150 [2]解放军第306医院医学检验科,北京100101

出　　处：《现代检验医学杂志》2018年第3期130-132,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探讨D-试验阳性现象的铜绿假单胞菌(PA)的发生率及其现象的发生机制。方法使用纸片扩散法(K-B法)检测386株PA对亚胺培南和头孢他啶的耐药性,对D-试验阳性及阴性株分别检测AmpC和金属β-内酰胺酶(MBLs)。结果 386株PA分离株中,有132株为D-试验阳性株,D-试验阳性的PA发生率为34.2%,总产酶率为73.5%,其中MBLs占40.1%,AmpC酶占30.3%,混合酶占3.0%。D-试验阴性株总产酶率为9.0%,其中MBLs占3.0%,AmpC酶占6.0%。两者在总产酶率、产MBLs和产AmpC酶方面的差异具有统计学意义(χ~2=39.9,26.4,14.7,均P<0.01)。其中98株(74.2%)菌株为D1型(亚胺培南耐药),34株(25.8%)菌株为D2型(亚胺培南敏感),D1型与D2型相比较,在产MBLs和产AmpC酶方面的差异具有统计学意义(χ~2=6.1,3.9,均P<0.05)。结论实验室应高度重视D-试验阳性的PA株的检测。推测PA株D-试验阳性现象的产生可能与MBLs和AmpC酶的大量产生有关。Objective To investigate the incidence rate of D-test-positive phenomenon and the mechamsm of the phenomenon- producing in Pseudomonas aeruginosa （PA）. Methods 386 PA clinical isolates were dectected to drug susceptibility of imi- penem and ceftazidime by K-B method,and D-test positive and negative trains were dectected to AmpC enzymes and MBLs, respectively. Results There were 132 D-test-positive trains in 386 PA clinical isolates, the incidence rate of D-test-positive trains was 34.2 %. In D-test-positive trains, total enzymes-producing rate was 73.5 % ,and MBLs, AmpC enzymes and MBLs ＋AmpC enzymeswas were 40.1%0,30.3 % and 3.0 %, respectively. In D-test-negative trains, total enzymes-producing rate was 9.0% ,and MBLs, AmpC enzymes were 3.0% and 6.0%, respectively. Compared withtotal enzymes-producing rate, AmpC enzymes and MBLs, D-test-positive trains had significant difference with negative ones （X^2 = 39.9,26.4,14.7, all P〈 0.01）. Dl-type trains were 74.2% and D2-type trains were 25.8%. Compared with MBLs and AmpC enzymes, Dl-type trainshad significant difference with D2-type trains （X^2 =6.1,3.9 ,all P〈0.05）. Conclusion Clinical microbiological labora- tory should highly pay attention to the detection in D-test-positive-PA strains. The production of MBLs and AmpC enzymes in great amount induced are probablely related to the phenomenon-producing in D-test-positive PA.

关 键 词：铜绿假单胞菌 Β-内酰胺酶 D试验 

分 类 号：R378.991[医药卫生—病原生物学] R446.5[医药卫生—基础医学]