铜绿假单胞菌产诱导型β内酰胺酶检测及其对20种抗生素耐药性分.docVIP

铜绿假单胞菌产诱导型β内酰胺酶检测及其对20种抗生素耐药性分 　【摘要】 目的 了解佛山地区铜绿假单胞菌临床分离产诱导型β内酰胺酶及其耐药性。方法 采用美国DADE产Micro Scan Auto Scan-4型微生物分析仪及其NC21鉴定及药敏板和符合NCCLS标准的Ver Sion 22分析软件，对128株铜绿假单胞菌检测产诱导型β内酰胺酶和对20种抗生素的敏感性。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57.0%~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）128株铜绿假单胞菌产诱导型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、安曲南诱导铜绿假单胞菌产诱导型β内酰胺酶的出现率为53.9%~80.0%。（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、复方新诺明的敏感性则完全相反（P＜0.05）。结论 佛山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、安曲南是强诱导剂，对于产酶菌株可选择环丙沙星、阿米卡星或联合使用耐酶的抗生素。 【关键词】 铜绿假单胞菌；诱导型β内酰胺酶；抗生素；抗药性 ［Abstract］ Objective To investigate the pseudomonas aeruginosa isolated from Qingyuan hospitals which produce inducible β-lactamase and their bacterial resistance.Methods 128 pseudomonas aeurginosa produce inducible β-lactamase and the susceptibility to 20 antibiotics were performed by Micro Scan Auto Scan-4 and plate NC21which was produced in USA,Ver Sion 22 analysis software according to the guidance of NDDLS was used.Results (1)In the 128 pseudomonas aeurginosa,the sensitive percentages to Ceftazidime,Piperacillin/Tazobactam,Ciprofloxacin,Amikacin,Cefepime,Imipenem carieties from 62.6%to 80.0%,other antibiotics had less susceptibility.(2)115 strains inducible β-lactamase in 128 pseudomonas aeruginosa(89.8%),which induced by Piperacillin/Tazobactam,Ceftazidime,Imipenem rates were from 64.3% to 86.1%.(3)115 strains inducible β-lactamase sensitive percentages to Piperaciuin/Tazobactam,Amikacin,Cefepime,Ceftazidime,Ciprofloxacin and Tobramycin were significantly higher than those non-inducible β-lactamase,but the sensitive percentages to Ampicillin/sulbacatam,were just on the contrary.Conclusion The rates of antibiotics inducing pseudomonas aeurginosa produce inducible β-lactamase are high in Qingyuan hospitals,Piperacillin/Tazobactam,Ceftazidime,Piperacillin and Aztreonam were strong inducer,Ciprofloxacin,Amikacin or other anti-enzyme antibiotics can be chosed