分离自院内感染患者不同标本的KP生物被膜形成能力及对常用抗菌药物耐药率观察  

Biofilm-forming ability and drug resistance of KP isolated from different samples of patients with nosocomial infection

作　　者：税剑 向延根[1,2] 石国民 喻容[1,2] 潘建华 SHUI Jian;XIANG Yangen;SHI Guomin;YU Rong;PAN Jianhua(Clinical Laboratory,Changsha Central Hospital,Changsha 410004,China)

机构地区：[1]长沙市中心医院检验科,长沙410004 [2]南华大学附属长沙中心医院检验科

出　　处：《山东医药》2022年第24期10-13,共4页Shandong Medical Journal

基　　金：湖南省自然科学基金(2021JJ40624);湖南省卫生健康委科研计划项目(202111000032);长沙市科技计划项目(kq2004166)。

摘　　要：目的 观察分离自院内感染患者不同标本的肺炎克雷伯菌(KP)生物被膜形成能力及对常用抗菌药物耐药率。方法 选取KP 96株,结晶紫染色法检测菌株的生物被膜形成能力,Vitek 2 Compact全自动微生物鉴定/药敏分析系统进行细菌鉴定及药物敏感性试验,并分析KP生物被膜形成能力与抗菌药物耐药性的关系。结果 96株KP中,有88株(91.7%)能够形成生物被膜,其中弱成膜14株(14.6%)、中等成膜39株(40.6%)、强成膜35株(36.5%)。KP对左氧氟沙星、复方新诺明、环丙沙星、多西环素具有较高的耐药率,耐药率分别为44.8%、43.7%、50.0%、45.8%;对美罗培南、亚胺培南、阿米卡星、多粘菌素B、替加环素耐药率较低,耐药率分别为18.7%、18.7%、12.5%、1.0%、4.2%。不同成膜能力KP对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、氨曲南、美罗培南、复方新诺明、头孢他啶、头孢比肟、亚胺培南、阿米卡星、环丙沙星、多西环素的耐药率不同,P均<0.05;KP对上述11种抗菌药物的耐药率不随生物被膜形成能力增强而升高,其中弱成膜组菌株耐药率最高,高于各组菌株(P均<0.05);中等成膜组菌株耐药率(除亚胺培南外)高于不成膜组及强成膜组(P均<0.05);强成膜组菌株(除头孢哌酮/舒巴坦、美罗培南、亚胺培南外)耐药率高于不成膜组(P均<0.05)。结论 KP大多能形成生物被膜,对各种抗菌药物呈不同程度耐药,KP对常用抗菌药物的耐药率不随生物被膜形成能力增强而升高。Objective To observe the biofilm-forming ability of Klebsiella pneumoniae(KP) isolated from different samples of patients with nosocomial infection and the resistance rate to common antibiotics.Methods Ninety-six KP strains were selected,and the biofilm-forming ability of the strains was detected by crystal violet staining.Vitek2 Compact automatic microbial identification/drug sensitivity analysis system were used for bacterial identification and drug sensitivity test,and the relationship between the biofilm-forming ability of KP and antimicrobial resistance was analyzed.Results Of the 96 KP clinical strains,88(91.7%) showed biofilm-forming ability.Among them,14(14.6%) isolates showed weak biofilm-forming ability,39(40.6%) exhibited moderate biofilm-forming ability,and 35(36.5%) showed strong biofilm-forming ability.KP had high resistance rates to levofloxacin,compound sulfamethoxazole,ciprofloxacin and doxycycline,with resistance rates of 44.8%,43.7%,50.0%,and 45.8%,respectively.The drug resistance rates to meropenem,imipenem,amikacin,polymyxin B and tigecycline were low,and the drug resistance rates were 18.7%,18.7%,12.5%,1.0%,and 4.2%,respectively.KP with different biofilm-forming abilities had different antibiotic resistance rates to piperacillin/tazobactam,cefoperazone/sulbactam,aztreonam,meropenem,compound sulfamethoxazole,ceftazidime,cefepime,imipenem,amikacin,ciprofloxacin,and doxycycline(all P<0.05).The antibiotic resistance rates of KP clinical strains to the above 11 antibiotics did not increase with the enhancement of biofilm-forming ability,and the antibiotic resistance rate of the strains in the weak biofilm-forming group was the highest,which was higher than those of the strains in other groups(all P<0.05).The antibiotic resistance rate of strains in the moderate biofilm-forming group(except IPM) was higher than those in the non-biofilm-forming group and strong biofilm-forming group(all P<0.05).The antibiotic resistance rate of strains in the strong biofilm-forming group(except SCF,MEM and IPM) was

关 键 词：肺炎克雷伯菌 细菌生物被膜 细菌耐药 

分 类 号：R446.5[医药卫生—诊断学]