神经外科多重耐药菌分布及耐药性研究  

Distribution and drug resistance of multidrug resistant bacteria in neurosurgery

作　　者：陈怡[1] 王耀武[1] 毕丽杰[1] CHEN Yi;WANG Yao-wu;BI Li-jie(Tangshan Workers’Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]唐山市工人医院,河北唐山063000

出　　处：《中国病原生物学杂志》2022年第3期337-339,343,共4页Journal of Pathogen Biology

基　　金：2015年度省卫计委医学科学研究重点课题(No.20150942)。

摘　　要：目的 研究神经外科多重耐药菌分布及耐药性,为神经外科感染治疗提供参考。方法 收集2018年1月-2019年12月本院神经外科患者档案资料,采集标本并进行培养和鉴定。肉汤稀释法测定菌株耐药性,K-B纸片扩散法测定耐甲氧西林金黄色葡萄球菌和肺炎克雷伯菌产ESBLs和AmpC酶菌。结果 神经外科送检标本中共分离出49株多重耐药菌,其中耐甲氧西林金黄色葡萄球菌7株(2018年5株,2019年1株),肺炎克雷伯菌25株(2018年6株,2019年19株),铜绿假单胞菌5株(2018年2株,2019年3株),鲍曼不动杆菌7株(2018年6株,2019年1株),脑膜脓毒性黄杆菌2株(2019年),大肠埃希菌1株(2019年),奇异变形杆菌1株(2019年),溶血不动杆菌1株(2019年)。肺炎克雷伯菌对头孢他啶、四环素、哌拉西林、哌拉西林/舒巴坦、环丙沙星、阿莫西林克/拉维酸钾、妥布霉素、阿米卡星、美罗培南和亚胺培南耐药株数分别为12、18、22、1、9、3、15、2、1和1株。铜绿假单胞菌对头孢他啶、四环素、哌拉西林、环丙沙星、阿莫西林克/拉维酸钾、妥布霉素、阿米卡星和美罗培南耐药株数分别为3、5、4、0、2、5、3、1和1株,未产生对哌拉西林/舒巴坦和亚胺培南耐药性。鲍曼不动杆菌对头孢他啶、四环素、哌拉西林、环丙沙星、阿莫西林克/拉维酸钾、妥布霉素和阿米卡星耐药株数分别为3、6、5、3、7、4和2株,未产生对哌拉西林/舒巴坦、美罗培南和亚胺培南的耐药性。14株产酶肺炎克雷伯菌,其中6株单产ESBLs酶,5株单产AmpC酶,3株ESBLs+AmpC酶。结论 检出的多重耐药菌中以肺炎克雷伯菌为主。肺炎克雷伯菌中检出ESBLs酶和AmpC酶,这可能是该菌对多种抗生素产生耐受性的原因。Objective To study the distribution and drug resistance of multi drug resistant bacteria in neurosurgery,so as to provide a strong basis for the treatment of Neurosurgery infection.Methods The archives of neurosurgical patients from January 2018 to December 2019 were collected,and specimens were collected,cultured and identified.The drug resistance of strains was determined by broth dilution method,and the ESBLs and AmpC enzyme producing Klebsiella pneumoniae strains and methicillin resistant Staphylococcus aureus were determined by K-B disk diffusion method.Result A total of 49 strains of multidrug-resistant bacteria were isolated from neurosurgical specimens,including 7 strains of MRSA(5 strains in 2018 and 1 strain in 2019),25 strains of K.pneumoniae(6 strains in 2018 and 19 strains in 2019),5 strains of P.aeruginosa(2 strains in 2018 and 3 strains in 2019),7 strains of A.baumannii(6 strains in 2018 and 1 strain in 2019),2 strains of flavobacterium menigosepticum(2019),and 1 strain of E.coli(2019),1 strain of Proteus mirabilis(2019),1 strain of Acinetobacter haemolyticus(2019).The resistant strains of K.pneumoniae to ceftazidime,tetracycline,piperacillin,piperacillin/sulbactam,ciprofloxacin,amoxicillin/potassium laverate,tobramycin,amikacin,meropenem and imipenem were 12,18,22,1,9,3,15,2,1 and 1.The resistant strains of P.aeruginosa to ceftazidime,tetracycline,piperacillin,ciprofloxacin,amoxicillin/potassium ravitate,tobramycin,amikacin and meropenem were 3,5,4,0,2,5,3,1 and 1,and there was no resistance to piperacillin/sulbactam and imipenem.The number of resistant strains of A.baumannii to ceftazidime,tetracycline,piperacillin,ciprofloxacin,amoxicillin/potassium ravirate,tobramycin and amikacin were 3,6,5,3,7,4 and 2.There was no resistance to piperacillin/sulbactam,meropenem and imipenem.14 strains of enzyme producing K.pneumoniae,including 6 strains of ESBLs enzyme,5 strains of AmpC enzyme and 3 strains of ESBLs + AmpC enzyme.Conclusion Among the multi drug resistant bacteria detected,K.pneumoniae was the

关 键 词：神经外科 病原菌 多重耐药 

分 类 号：R378[医药卫生—病原生物学]