摘要
目的 研究肺炎克雷伯菌对头孢他啶/阿维巴坦的耐药情况,以期为临床抗感染用药选择提供参考。方法 选取2024年1月至2024年12月徐州中西医结合医院检验科检出的109株肺炎克雷伯菌进行药敏试验分析。对耐碳青霉烯类肺炎克雷伯菌的碳青霉烯酶、金属β-内酰胺酶使用改良碳青霉烯类灭活法、乙二胺四乙酸碳青霉烯类灭活法进行检测;进一步做碳青霉烯酶抑制增强试验,对耐碳青霉烯类肺炎克雷伯菌的丝氨酸酶、金属β-内酰胺酶进行检测。结果 109株肺炎克雷伯菌中,12株耐碳青霉烯类肺炎克雷伯菌主要分离自重症监护室;109株肺炎克雷伯菌对头孢他啶/阿维巴坦有着高达93.58%的敏感率;12株耐碳青霉烯类肺炎克雷伯菌对头孢他啶/阿维巴坦的敏感率是83.33%;12株耐碳青霉烯类肺炎克雷伯菌中,10株(83.33%)改良碳青霉烯类检测阳性,产碳青霉烯酶,其中2株乙二胺四乙酸碳青霉烯类灭活阳性,产金属β-内酰胺酶;12株耐碳青霉烯类肺炎克雷伯菌做碳青霉烯酶抑制增强试验,其中产丝氨酸的有8株(66.67%),产金属β-内酰胺酶的有2株(16.67%),还有2株同时产丝氨酸酶与金属β-内酰胺酶。结论 肺炎克雷伯菌对头孢他啶/阿维巴坦的敏感性比较高,可将此用做耐碳青霉烯类药肺炎克雷伯菌造成严重感染的治疗手段;同时,积极做药敏试验和碳青霉烯酶耐药基因鉴定,亦可指导临床抗菌药物的规范选用。
Objective To investigate the resistance of Klebsiella pneumoniae to cefotaxime/avibactam,in order to provide reference for the selection of clinical anti infective drugs.Methods Select 109 strains of Klebsiella pneumoniae detected by the Laboratory Department of Xuzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2024 to December 2024 for drug susceptibility testing analysis.Detection of carbapenemases and metalβ-lactases in carbapenem resistant Klebsiella pneumoniae using modified carbapenem inactivation method and ethylenediaminetetraacetic acid carbapenem inactivation method;Further conduct experiments to enhance the inhibition of carbapenems and detect serine enzymes and metalβ-lactases in carbapenem resistant Klebsiella pneumoniae.Results Among the 109 strains of Klebsiella pneumoniae,12 strains of carbapenem resistant Klebsiella pneumoniae were mainly isolated from the intensive care unit;109 strains of Klebsiella pneumoniae had a sensitivity rate of up to 93.58%to cefotaxime/avibactam;The sensitivity rate of 12 strains of carbapenem resistant Klebsiella pneumoniae to cefotaxime/avibactam was 83.33%;Among 12 strains of carbapenem resistant Klebsiella pneumoniae,10 strains(83.33%)tested positive for modified carbapenems and produced carbapenemases.Among them,2 strains tested positive for ethylenediaminetetraacetic acid carbapenem inactivation and produced metalβ-lactams;12 strains of carbapenem resistant Klebsiella pneumoniae were subjected to carbapenem enzyme inhibition enhancement tests,among which 8 strains(66.67%)produced serine,2 strains(16.67%)produced metalβ-lactase,and 2 strains simultaneously produced serine enzyme and metalβ-lactase.Conclusion Klebsiella pneumoniae is highly sensitive to cefotaxime/avibactam and can be used as a treatment for severe infections caused by carbapenem resistant Klebsiella pneumoniae;Meanwhile,actively conducting drug sensitivity tests and identifying carbapenem resistance genes can also guide the standardized selection of clinical antibiotics.
作者
成强
周红梅
CHENG Qiang;ZHOU Hongmei(Department of Laboratory Medicine,Xuzhou Integrated Traditional Chinese and Western Medicine Hospital/Xuzhou Mining Hospital,Xuzhou 221002,China)
出处
《中国处方药》
2025年第24期104-107,共4页
Journal of China Prescription Drug
