耐亚胺培南铜绿假单胞菌的药敏情况与耐药机制

目的：探讨44株耐亚胺培南铜绿假单胞菌的药敏情况和产金属β-内酰胺酶的类型。方法：采用K-B法测定抗菌药物对细菌的体外抗菌活性，双纸片协同试验进行金属β-内酰胺酶筛选，PCR法进行金属β-内酰胺酶耐药基因IMP和IMP的检测。结果：阿米卡星敏感性最高为27．3％，其次为环丙沙星（20．5％）和头孢吡肟（15．9%）；44株耐亚胺培南铜绿假单胞菌中，扩增出IMP型阳性株4株，未检测到VIM型金属β-内酰胺酶基因。结论：对耐亚胺培南铜绿假单胞菌引起的感染，阿米卡星、环丙沙星和头孢吡肟可以考虑使用。北京天坛医院耐亚胺培南铜绿假单胞菌耐药机制中，产IMP型金属β-内酰胺酶起着重要作用。

Antimicrobial Susceptibility and Resistance Mechanism of Pseudomonas Aeruginosa Resisting to Imipenem

Objective：To investigate the resistance and metallo beta-lactamase of 44 strains of imipenem-resistant pseudomonas aeruginosa. Methods：Antimicrobial activity to 44 strains of pseudomonas aeruginosa were determined by K B test, and the double-disk synergy test was used to screen metallo-beta-lactamase. PCR method was used to detect IMP gene and VIM gene. Results：The susceptibility rates to amikacin, ciprofloxacin,cefepime were 27. 3%,20. 5%, 15.9% ;respectively. Four among 44 imipenem-resistant Pseudomonas aeruginosa strains were positive for IMP gene ,all 44 strains were negative for VIM gene. Conclusions..Amikacin, ciprofloxacin and cefepime will have better effect in treating the infection aroused by Pseudomonas aeruginosa resisting to imipenem. The production of IMP type metallo beta-lactamase is the main mechanism for imipenem resistance of Pseudomonas aeruginosa in Beijing Tiantan Hospital.