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产金属β内酰胺酶铜绿假单胞菌呼吸机相关肺炎暴发临床分析 被引量:15

Clinical analysis on an outbreak of ventilator-associated pneumonia caused by metallo-β-lactamase-producing Pseudomonas aeruginosa in respiratory intensive care unit
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摘要 目的探讨呼吸重症监护病房(RICU)产金属口内酰胺酶(MBLs)铜绿假单胞菌暴发流行的可能原因。方法对2002年1—4月RICU内6例行气管插管机械通气,并于支气管灌洗液中多次分离到多重耐药铜绿假单胞菌(MRPA)的呼吸机相关肺炎(VAP)病人进行调查。结果6例分离到的MRPA菌株MBLs阳性,经DNA分析为同一菌株暴发流行所致。其中4例死亡,2例好转。调查发现呼吸机出气口和湿化瓶有MRPA生长。结论产MBLs铜绿假单胞菌为泛耐药菌株,目前尚缺乏有效的治疗手段,在RICU内一旦出现,如不注意隔离,可造成该菌株的暴发流行。 Objective To investigate an outbreak of ventilator-associated pneumonia (VAP) caused by metallo-β-lactamase(MBLs)-producing Pseudomonas aeruginosa in respiratory intensive care unit (RICU) in Guangzhou first people' s hospital. Methods The clinical, epidemiological and bacterial data of 6 cases with VAP caused by mulfidrug resistant Pseudomonas aeruginosa in the outbreak from Jan 2002 to Apr 2002 were retrospectively analysed. Results Six strains of muhidrug resistant Pseudomonas aeruginosa from 6 patients were shown to produce MBLs. These muhidrug resistant Pseudomonas aeruginosa were resistant to ciprofloxacin, cefoperazone/sulbactam, piperacillin/tazobactam, ceftazidime, meropenem, imipenem, cefepime, piperacillin, amikacin, netilmicin, aztreonam and cefoperazone. Random amplified polymorphic DNA typing verified that the 6 strains had the same origination. Of 6 patients, 4 elder cases died, and 2 young cases survived.The same strain were also isolated from expiratory outlets and humidifiers of the respirators. Conchusions This MBLs-producing Pseudomonas aeruginosa is a pan-antibiotic resistant strain without effective treatment currently. Neglect of isolation and sterilzation could cause an outbreak of MBLs-producing mulfidrug resistant Pseudomonas aeruginosa in intensive care unit.
出处 《中国呼吸与危重监护杂志》 CAS 2006年第3期168-171,共4页 Chinese Journal of Respiratory and Critical Care Medicine
基金 广东省自然科学基金资助(5000423)
关键词 金属Β内酰胺酶 铜绿假单胞菌 呼吸机相关肺炎 Metallo-β-lactamase Pseudomonas aeruginosa Ventilator-associated pneumonia
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参考文献10

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