摘要
目的:分析医院老年患者感染铜绿假单胞菌对抗菌药物的耐药性及其对产金属酶表型的检测情况。方法:抽取医院2017年3月-2019年3月间收治的老年住院患者的各类临床标本(采用美国BD凤凰100型细菌鉴定系统分离和鉴定)的细菌鉴定和药敏试验资料,分析其耐亚胺培南的菌株对产金属酶表型检测结果及其耐药性。结果:分离出的215株铜绿假单胞菌中,其对多粘菌素均敏感,而对阿米卡星呈低耐药(耐药率为4.19%);其对环丙沙星与左氧氟沙星的耐药率分别为39.53%和36.74%,以及对亚胺培南、美罗培南的耐药率分别为16.74%和12.56%;另外,36株耐亚胺培南的铜绿假单胞菌,采用组合纸片法筛选出1株产金属酶菌株。结论:针对医院老年患者中铜绿假单胞菌对抗菌药物均有不同程度的耐药,临床医生应遵循抗铜绿假单胞菌的治疗原则,合理选用抗菌药物治疗,同时规范控制高危感染因素;并且加强对铜绿假单胞菌耐药的趋势监测,尤其是碳青霉烯类药物,以便采取有效措施控制铜绿假单胞菌耐药的发展。
Objective: To analyze the antimicrobial resistance of Pseudomonas aeruginosa infection in elderly patients in hospital and to detect the metalloenzyme phenotype. Methods: The data of bacterial identification and drug susceptibility test were extracted from various clinical specimens of elderly inpatients admitted to the hospital from March2017 to March 2019(isolated and identified by BD phoenix 100 bacterial identification system of the United States).The phenotype of the strain resistant to imipenem and its resistance to metalloenzyme were analyzed. Results: The 215 isolates of Pseudomonas aeruginosa were all sensitive to polymyxins, but showed low drug resistance to amikacin(drug resistance rate was 4.19%). The drug resistance rates of ciprofloxacin and levofloxacin were 39.53% and 36.74%, respectively, and the drug resistance rates of imipenem and meropenem were 16.74% and 12.56%, respectively. In addition, one of 36 imipenem-resistant Pseudomonas aeruginosa strains was screened out by the combined paper method.Conclusion:In view of the different degrees of resistance of pseudomonas aeruginosa to antimicrobial agents in elderly patients in hospital, clinicians should follow the treatment principle of anti-pseudomonas aeruginosa, select appropriate antimicrobial agents for treatment, and standandize the control of high-risk infectious factors. In addition, the trend of drug resistance of pseudomonas aeruginosa should be monitored, especially carbapenems, so as to take effective measures to control the development of drug resistance of pseudomonas aeruginosa.
作者
张丹
罗世荣
周世娟
余进胜
ZHANG Dan;LUO Shi-rong;ZHOU Shi-juan;YU Jin-sheng(Department of Clinical Laboratory,Huidong County People's Hospital,Huidong Guangdong 516300,China)
出处
《抗感染药学》
2019年第11期1860-1862,共3页
Anti-infection Pharmacy
基金
惠州市科技计划项目（编号：2018Y335）
关键词
老年患者
铜绿假单胞菌
抗菌药物
碳青霉烯类药物
耐药性
elderly patients
Pseudomonas aeruginosa
antimicrobial agents
carbapenems
drug resistance
