2018-2020年本院耐碳青霉烯类铜绿假单胞菌的产酶情况及耐药性分析  

Distribution and Drug Resistance Analysis of Carbapenem-resistant Pseudomonas Aeruginosa from 2018 to 2020

作　　者：刘敏娟 庞彩莲 吴品 陈凯妮 黄嘉莹 LIU Minjuan;PANG Cailian;WU Pin;CHEN Kaini;HUANG Jiaying(Dongguan Dalang Hospital,Dongguan 523770,China;不详)

机构地区：[1]东莞市大朗医院,广东东莞523770

出　　处：《中外医学研究》2022年第11期64-67,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:了解东莞市大朗医院2018-2020年检出的耐碳青霉烯类铜绿假单胞菌(CRPA)的产碳青霉烯酶情况和耐药性分析,为临床治疗提供合理的抗菌药物。方法:收集东莞市大朗医院2018年1月-2020年12月CRPA菌株66株,采用eCIM实验筛查碳青霉烯酶,双纸片扩散法检测产酶表型,通过全自动微生物鉴定仪VIEK2-Compact对66株CRPA进行鉴定及药敏试验,采用WHONET 5.6软件进行分析。结果:在465株铜绿假单胞菌中共检出CRPA菌株66株(检出率为14.2%),标本来源以呼吸道痰液标本为主,占65.2%,非呼吸道占34.8%。在临床科室分布中,ICU检出率最高,其次为呼吸内科及烧伤整形外科。在66株CRPA中,产碳青霉烯酶占33.3%,其中单一产丝氨酸酶占16.7%,单一产金属酶占12.1%,同时产丝氨酸酶和金属酶占4.5%,不产碳青霉烯酶占66.7%。66株CRPA的药敏结果中亚胺培南和美罗培南的耐药率较高分别为97.0%和71.2%,其次为氨曲南51.5%,其余耐药率均<30%,哌拉西林为27.3%,哌拉西林/他唑巴坦为22.7%,头孢他啶16.7%,头孢吡肟12.1%,环丙沙星12.1%,左旋氧氟沙星9.1%,庆大霉素9.1%,妥布霉素9.1%,阿米卡星为4.5%。结论:标本来源以痰标本为主,主要分布在ICU及呼吸内科,产碳青霉烯酶不是东莞地区铜绿假单胞菌对碳青霉烯类抗生素耐药的主要机制,耐药分析中耐药率绝大部分<30%,其中喹诺酮类及氨基糖苷类耐药率相对较低,临床根据药敏试验合理选择抗菌药物可防止CRPA的蔓延及传播。Objective:To understand carbapenemase and the drug resistance of the carbapenem-resistant Pseudomonas aeruginosa(CRPA)produced by Dongguan Dalang Hospital from 2018 to 2020,so as to provide reasonable clinical treatment of antibacterial drugs.Method:A total of 66 CRPA strains in Dongguan Dalang Hospital from January 2018 to December 2020 were collected.The eCIM experiment was used to screen carbapenemase,and the double-disc diffusion method was used to detect the enzyme-producing phenotype.The CRPA strains were identified and tested for drug sensitivity by VIEK2-Compact automatic microorganisms analyzer,and analyzed using WHONET 5.6 software.Result:A total of 66 CRPA strains were detected in 465 Pseudomonas aeruginosa strains(detection rate was 14.2%).The main source of specimens was respiratory sputum specimens,which accounted for 65.2%,and non-respiratory tracts accounted for 34.8%.In the distribution of clinical departments,ICU had the highest detection rate,followed by respiratory medicine and burn plastic surgery.Among 66 CRPA strains,carbapenemase production accounted for 33.3%,of which single serinase production accounted for 16.7%,single metalloenzyme production accounted for 12.1%,and both serinase and metalloenzyme production accounted for 4.5%,and no carbapenemase production accounted for 66.7%.In the drug susceptibility results of 66 CRPA strains,the drug resistance rates of Imipenem and Meropenem were higher than 97.0%and 71.2%,respectively,followed by Aztreonam at 51.5%,the rest resistance rates were all<30%,and Piperacillin was 27.3%,Piperacillin/Tazobactam 22.7%,Ceftazidime 16.7%,Cefepime 12.1%,Ciprofloxacin 12.1%,Levofloxacin 9.1%,Gentamicin 9.1%,Tobramycin 9.1%and Amikacin at 4.5%.Conclusion:The main source of specimens is sputum specimens,which are mainly distributed in ICU and respiratory medicine.Carbapenemase production is not the main mechanism of resistance of Pseudomonas aeruginosa to carbapenem antibiotics in Dongguan.The drug resistance is analyzed in the drug resistance analysis,most o

关 键 词：耐碳青霉烯类铜绿假单胞菌 丝氨酸酶 金属Β内酰胺酶 耐药性 

分 类 号：R446.5[医药卫生—诊断学]