临床分离48株铜绿假单胞菌的耐药性分析及其耐药质粒检测

目的了解铜绿假单胞菌临床分离株对抗生素的耐药性及其耐药质粒情况,为临床用药提供直接可靠的参考依据。方法采用美国临床实验室标准委员会（NCCLS）推荐的标准方法（K-B法）对从校医院临床病例分离的48株铜绿假单胞菌进行药敏试验,并以碱裂解法提取和检测其耐药质粒。结果在48株铜绿假单胞菌中,对临床常用抗生素敏感性较好的是妥布霉素、丁胺卡那霉素和环丙沙星,其敏感率分别为83.3%、79.2%和75.0%,而耐药性较高的是复方新诺明、呋喃妥因和氨苄青霉素,其耐药率分别为87.5%、77.1%和72.9%：对其中8株多重耐药菌株进行质粒提取,发现4株菌携带有大小约为23～25kb的质粒DNA,经质粒消除试验表明,上述质粒与铜绿假单胞菌的多重耐药性有关。结论铜绿假单胞菌对复方新诺明、呋喃妥因和氨苄青霉素等已高度耐药,临床上不宜选用;耐药质粒对在铜绿假单胞菌耐药性的产生和传播具有重要作用。

Analysis on Antibiotics Resistance of 48 Isolates of Pseudomonas Aeruginosa and Detection of Their Plasmids

[Objective]To investigate the antibiotics resistance of pseudomonas aeruginosa isolates and status of their plasmids,and provide reliable reference for clinical drug use.[Methods]The drug sensitivity of 48 isolates from clinical cases in hospital were investigated by K-B methods recommended by NCCLS,and their drug resistance plasmids were extracted and detected by the alkaline fission method.[Results]The sensitive antibiotics to the 48 isolates were tobramycin,amikacin and ciprofloxacin,and the sensitive rate was 83.3%,79.2% and 75.0% respectively.The resistable antibiotics were sinomin,furadantin and ampicillin and the resistance rate was 87.5%,77.1% and 72.9% respectively.The plasmid DNA of 23～25kb was found in 4 of 8 multi-resistant strains,and these plasmids had relation with the multi-resistance of pseudomonas aeruginosa by plasmid elimination test.[Conclusion]Pseudomonas aeruginosa has been highly resistant to cotrimoxazole,nitrofurantoin and ampicillin which should not be clinical used.Resistance plasmid plays an important role in generation and dissemination of antibiotics resistance of pseudomonas aeruginosa.