摘要
目的了解鲍氏不动杆菌的耐药性与产β-内酰胺酶的关系。方法对分离出的细菌采用API2 0NE系统进行鉴定，药敏试验采用K—B法，用改良三维试验检测菌株产β-内酰胺酶的情况，用2-巯基丙酸抑制试验筛选金属酶。结果在150株鲍氏不动杆菌中，头孢哌酮／舒巴坦的耐药率最低（4．0％），其次为亚胺培南、美罗培南、哌拉西林／他唑巴坦、氨苄西林／舒巴坦和左氧氟沙星（耐药率从20．0％～55．0％），耐药率最高的是头孢他啶、头孢吡肟、氨曲南和阿米卡星，均〉60．0％；在所有菌株中有37株（24．7％）产ESBLS，66株（44．0％）产AmpC酶，16株（10．7％）产碳青酶烯酶，其中12株（8．0％）为金属酶。结论除头孢哌酮／舒巴坦和碳青酶烯类抗菌药物外，鲍氏不动杆菌对临床常用的其他抗菌药物耐药率均较高，产ESBLs、AmpC酶和金属酶是其对多种抗菌药物高度耐药的主要原因。
OBJECTIVE To investigate the relationship METHODS The bacteria cultured were identified with of resistance and β-lactamases of Acinetobacter baumannii. API 20NE system. The susceptibilities of the bacteria were detected by disk diffusion method. The β-lactamases produced by these strains were characterized by three- dimensional test and 2-mercaptopropionic acid inhibition assays. RESULTS In 150 strains, the resistant rates of strains were 4. 0% to cefoperazone/sulbactam. The resistant rates to imipenem, meropenem, piperacillin/ tazobactam, ampicillin/sulbactam and levofloxacin were between 20. 0% and 55. 0%. The resistant rates to ceftazidime, cefepime, aztreonam and amikacin were above 60.0 %. Three-dimensional test showed that 37 strains （24.7%） produced extended spectrum β-lactamases （ESBLs）, 66 strains（44.0%）produced AmpC enzymes and 16 strains （ 10. 7%） produced carbapenemases, in which 12 strains （ 8.0% ） produced metallo-β-tactamases. CONCLUSIONS The resistant rates of A. baumannii to routine antibiotics are high except cefoperazone/sulbactam and carbapenem. It is the most important reason for multi-drug resistance that the strains of A. baumannii produce ESBLs, AmpC enzymes and metallo-β-lactamases.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第16期2185-2187,共3页
Chinese Journal of Nosocomiology
