引起耳道感染的产生物膜铜绿假单胞菌的流行病学分析  

Epidemiological analysis of biofilm Pseudomonas aeruginosa causing ear canal infections

作　　者：叶丽艳[1] 王玥 宋林键 赵强[1] 杨继勇[1] 王成彬[1] 罗燕萍[1] YE Liyan;WANG Yue;SONG Linjian;ZHAO Qiang;YANG Jiyong;WANG Chengbin;LUO Yanping(Department of Laboratory Medical Center,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;College of Laboratory Medicine,Chongqing Medical University,Chongqing 401331,China)

机构地区：[1]解放军总医院第一医学中心医学检验中心,北京100853 [2]重庆医科大学检验医学院,重庆401331

出　　处：《国际检验医学杂志》2020年第11期1287-1290,1295,共5页International Journal of Laboratory Medicine

基　　金：国家重点研发计划(2017YFC1601405)。

摘　　要：目的了解解放军总医院耳鼻喉外科耳道感染患者标本中分离的铜绿假单胞菌的人群分布、生物膜产生情况及耐药情况等流行病学特征,为临床提供重要依据。方法采用Vitek MS质谱仪进行细菌鉴定,药敏试验采用纸片扩散法(K-B法)或Vitek 2 Compact全自动细菌鉴定药敏仪,按美国临床实验室标准化协会2016-M100的标准进行药敏结果分析,用结晶紫染色法检测铜绿假单胞菌生物膜并对生物膜形成能力进行判定。结果2013-2017年解放军总医院共收集到与耳道感染相关的铜绿假单胞菌106株,各年龄段均有检出;形成生物膜的菌株占80.20%,复发病例分离的菌株中可形成生物膜的菌株比例(81.25%)高于未复发病例分离的菌株(78.57%);不同生物膜形成能力的菌株抗菌药物敏感率差异无统计学意义(P>0.05),产膜菌株对亚胺培南、头孢他啶和左氧氟沙星比未产膜菌株的敏感性略高;复发组与未复发组菌株的抗菌药物敏感性差异均无统计学意义(P>0.05),复发组的头孢他啶、亚胺培南、美罗培南、左氧氟沙星、哌拉西林、氨曲南和头孢哌酮/舒巴坦的抗菌药物敏感率稍高于未复发组;11.10 mmol/L葡萄糖可促进生物膜的形成,15.00μg/mL壳聚糖季铵盐对生物膜的形成有一定抑制作用。结论引起耳道感染的铜绿假单胞菌生物膜形成能力较强,生物膜的形成与疾病复发有一定的关系;降低血糖水平及使用壳聚糖季铵盐凝胶对抑制生物膜形成有一定的作用。Objective To understand the population distribution,biofilm generation,and drug resistance of Pseudomonas aeruginosa(Pae)isolated from specimens of ear canal infections in patients with otolaryngology surgery at the Chinese PLA General Hospital,and to provide important evidence for clinical use.Methods Vitek MS mass spectrometer was used for bacterial identification,K-B method or Vitek 2 Compact was used for drug sensitivity test,and the results were analyzed according to CLSI 2016-M100 standard.Crystal violet staining method was used to detect the biofilm of Pae and determine the biofilm formation ability.Results From 2013 to 2017,106 strains of Pae were collected in Chinese PLA General Hospital,which were related to the infection of ear canal,and were detected in all ages.80.20%strains formed biofilm,81.25%of which could form biofilm in recurrent cases was higher than that in non recapsed group(78.57%).There was no significant difference in antimicrobial susceptibility among strains with different biofilm forming ability(P>0.05).Imipenem,ceftazidime and levofloxacin in biofilm forming strain were slightly more sensitive than those without biofilm;there was no significant difference in antimicrobial susceptibility between the relapsed group and the non relapsed group(P>0.05).The drug Sensitivity of Ceftazidime,imipenem,meropenem,levofloxacin,piperacillin,aztreonam and Cefoperazone/sulbactam in the relapsed group were slightly higher than those in the non relapsed group;11.10 mmol/L of glucose promoted the formation of biomembrane,and 15.00μg/mL of chitosan quaternary ammonium salt inhibited the formation of biomembrane.Conclusion Pae causing the infection of ear canal has strong biofilm formation ability.The formation of biofilm has a certain relationship with the recapse of disease.Lowering the blood sugar concentration and using chitosan quaternary ammonium salt gel can inhibit the formation of biofilm.

关 键 词：耳道感染 铜绿假单胞菌 生物膜 耐药 

分 类 号：R378[医药卫生—病原生物学]