铜绿假单胞菌产诱导型β-内酰胺酶检测及其对20种抗生素的耐药分析  

Detection of inducible β-lactamase producing Pseudomonas aeruginosa and their resistance to 20 antibiotics

作　　者：李介华[1] 苏丹[2] 梁金水[1] 袁春雷[1] 

机构地区：[1]暨南大学医学院第五附属医院暨清远市人民医院,清远511500 [2]广东省英德市人民医院,英德513000

出　　处：《中国抗生素杂志》2003年第5期280-282,303,共4页Chinese Journal of Antibiotics

摘　　要：目的　了解本地区铜绿假单胞菌临床分离株产诱导型 β 内酰胺酶的情况及其耐药性。方法　采用美国DADE产MicroScanAutoScan 4型微生物分析仪及其NC2 1鉴定板检测 12 8株铜绿假单胞菌对 2 0种抗生素的敏感性 ,用符合NCCLS标准的Version 2 2分析软件对 12 8株铜绿假单胞菌产诱导 β 内酰胺酶情况进行分析。结果　 ( 1)铜绿假单胞菌对头孢他啶、哌拉西林 /三唑巴坦、环丙沙星、阿米卡星、头孢吡肟、亚胺培南的敏感性高达 62 6%～ 80 0 %之间 ,妥布霉素、哌拉西林、庆大霉素次之 ,而其他头孢菌素敏感性低下 ;( 2 ) 12 8株铜绿假单胞菌产 β 内酰胺酶者 115株 ( 89 8% ) ,在产诱导型 β 内酰胺酶菌株中 ,哌拉西林 /三唑巴坦、头孢他啶、哌拉西林、氨曲南诱导铜绿假单胞菌产诱导型 β 内酰胺酶的出现率为 64 3 %～ 86 1% ;( 3 )产诱导型 β 内酰胺酶株对哌拉西林 /三唑巴坦、阿米卡星、头孢吡肟、头孢他啶、环丙沙星、妥布霉素等抗生素的敏感性显著高于不产诱导型 β 内酰胺酶株 ,而氨苄西林 /舒巴坦、SMZ/TMP的敏感性则完全相反 (P <0 0 5或 0 0 0 5 )。结论　本地区抗生素诱导铜绿假单胞菌产诱导型 β 内酰胺酶率较高 ,哌拉西林 /三唑巴坦、头孢他啶、哌拉西林、氨曲南是强诱导剂 ,对于产酶菌株可选择?Objective To investigate the inducible β lactamase (IB) producing Pseudomonas aeruginosa isolated from Qingyuan hospitals and their bacterial resistance. Method 128 Pseudomonas aeruginosa producing inducible β lactamase and the susceptibility to 20 antibiotics were performed by MicroScan AutoScan 4 and plate NC21, Version 22 analysis software according to the guidence of NCCLS was used. Results (1) In the 128 Pseudomonas aeruginosa , the senstivity percentages to ceftazidime, piperacilin/tazobactam, ciprofloxacin, amikacin, cefepime, imipenem varied from 62 6% to 80 0%, other antibiotics were less susceptible; (2) 115 strains produced inducible β lactamase in 128 Pseudomonas aeruginosa (89 8%), and those induced by piperacillin/tazobactam, ceftazidime, piperacillin, aztreonam rated from 64 3% to 86 1%; (3) The senstivities of inducible β lactamase producing strains to piperacillin/tazobactam, amikacin, cefepime, ceftazidime, ciprofloxacin and tobramycin were significantly higher than those non inducible β lactamase strains, but the senstivity to ampicillin/sulbactam were just on the contrary. Conclusions The rates of inducible β lactamase induced by antibiotics in Pseudomonas aeruginosa were high in Qingyuan hospitals. Piperacillin/tazobactam, ceftazidime, piperacillin and aztreonam were strong enzyme inducer. Cipro floxacin, amikacin or combined therapy of other enzyme inhibitor could be chosen for the treatment of enzyme producing bacterial infections.

关 键 词：铜绿假单胞菌 诱导型Β-内酰胺酶 抗药性 抗生素 

分 类 号：R378.991[医药卫生—病原生物学]