摘要
目的分析二级医院临床分离铜绿假单胞菌抗菌药物敏感性和金属酶、β-内酰胺酶流行情况,指导临床用药。方法回顾性分析2013年2月-2015年10月医院临床分离的非重复铜绿假单胞菌318株,所有菌株均用K-B法进行药敏试验;收集30株耐亚胺培南铜绿假单胞菌,采用聚合酶链反应(PCR)检测4种碳青霉烯酶耐药基因IMP、VIM、OXA-10、OXA-23。结果铜绿假单胞菌对阿米卡星耐药率最低,对头孢哌酮/舒巴坦、环丙沙星、哌拉西林/他唑巴坦、头孢他啶、亚胺培南耐药率依次为27.9%,30.9%,33.0%,34.2%,35.7%,对哌拉西林、美洛西林耐药率较高,耐药率分别为42.0%、54.6%。经基因检测发现VIM型阳性株24株,OXA-10阳性株1株,未扩增出IMP、OXA-23阳性株。结论基层医院铜绿假单胞菌耐药率也很高,以产金属β-内酰胺酶为主,OXA酶检出率较低,基因型为OXA-10。
OBJECTIVE To analyze the antimicrobial susceptibility of clinical isolates of Pseudomonas aeruginosa and the prevalence of the metalto-^-lactamase in three hospitals, so as to guide clinical drug use. METHODS A to- tal of 318 non-repetitive strains of P. aeruginosa isolated from hospital of Liaocheng from Feb. 2013 to Oct. 2015 were retrospectively analyzed, and all strains were tested by K-B method for drug sensitivitY test. A total of 30 strains of imipenem-resistant P. aeruginosa were performed to polymerase chain reaction （PCR） to detect 4 kind of earbapenem-resistant genes, including IMP, VIM, OXA-IO and OXA-23. RESULTS The resistant rate of P. aeruginosa to amikacin was the lowest（17.7%）. The resistant rates to cefoperazone su!bactam, ciprofloxacin, piperacillin tazobactam, eeftazidime, and imipenem were 27.9%, 30.9%, 33.0%, 34.2%, and 35.7%, respec- tively, and to piperacillin and mezlocillin were higher, which were 42.0% and 54.6%. Totally 24 VIM gene posi- tive strains and 10XA-IO gene positive strain were detected by gene deTection, and IMP and OXA-23 positive strains were not amplified. CONCLUSION The drug resistant rate of P. aeruginosa in primary hospital is high, which is mainly the metallo-β-lactamase. The detection rate of OXA enzyme in the hospital is low, and the main gene type is OXA-10.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第1期43-46,共4页
Chinese Journal of Nosocomiology
