烧伤创面铜绿假单胞菌的分离和耐药谱分析

目的　探讨烧伤创面铜绿假单胞菌耐药谱的变迁及诱导型 β 内酰胺酶的产生。 方法对笔者医院 1996年 6月～ 2 0 0 0年 6月鉴定的 4 5 2株烧伤创面铜绿假单胞菌 ,用VITEK AMS全自动细菌鉴定及药敏系统、E test浓度梯度法做药敏试验 ,以K B法为基础作诱导酶的检测。　结果　 4年中临床常用的头孢菌素及亚胺培南的耐药率均有提高 ;其中以头孢哌酮 /舒巴坦的耐药率最低 ,但 4年中耐药率的变化差异也有显著性意义 (P <0 .0 5 ) ,亚胺培南的耐药率在 2 0 %～ 4 0 %之间。 12 0株野生型铜绿假单胞菌中 ,以亚胺培南为诱导剂 ,检出产生诱导酶者为 72 .5 %。　结论　烧伤创面铜绿假单胞菌耐药谱的分析和诱导酶的检测 ,可以及时监控和调整抗生素的使用 ,对避免铜绿假单胞菌在医院内流行具有重要意义

The isolation of Pseudomonas aeruginosa from burn wound and the analysis of its antibiotic resistant spectrum

OBJECTIVE: To investigate the change in the antibiotic resistant spectrum of Pseudomonas aeruginosa (PA) isolated from burn wounds and the production of inducible beta-lactamase. METHODS: VITEK-AMS system (total automatic bacterial identification and drug sensitivity system) and E-test concentration gradient were employed to perform bacterial identification and antibiotic sensitivity tests. K-B method was applied to detect inducible enzyme. RESULTS: The resistance of PA to Cephalosporin and Imipenem was increased in the past 4 years from June of 1996 to June of 2000. Whereas the resistance to Cefoperazone/Sulbactam was least. There was an obvious difference of the resistance of PA to antibiotics during the 4 years (P < 0.05). The resistant rate to Imipenem ranged from 20% to 40%. PA was able to produce inducible enzymes among 120 strains of wild type of PA occupying 72.5% with Imipenam as the inducing agent. CONCLUSION: The analysis of the antibiotic resistance of PA and the detection of inducible enzymes could be monitored from time to time and helpful in the correction of the use of antibiotics. Constant monitoring of antibiotic resistance might be beneficial to the prevention of outbreak of epidemics of PA infection in a burn unit.