儿童医院159株绿脓杆菌药敏试验及质粒分析

研究目的 研究儿童医院绿脓杆菌耐药性与质粒的关系。 研究方法 从烧伤病房、PICU、普通病房采集的绿脓杆菌分别为59、42、58株。87株带质粒(观察组),53株不带质粒(对照组)。用微量稀释法对159株绿脓杆菌进行13种抗生素的药敏试验;140株菌的质粒提取用改良Birnboim法。 研究结果 94.5％的菌株对丁胺卡那霉素及头孢噻甲羧肟敏感,MIC_(90)均为16mg/L,仅23.3％菌株对庆大霉素敏感。烧伤病房及PICU的绿脓杆菌对头孢噻甲羧肟、噻肟单酰胺菌素、头了解三嗪、羧苄青霉素、头孢氨噻肟及庆大霉素耐药率明显高于普通病房的绿脓杆菌。质粒检出率62.1％(87/140),37.9％(53/140)菌株不带质粒。对庆大霉素、头孢氨噻肟、羧苄青霉素及头孢三嗪,含质粘菌株耐药率明显高于不含质粒株。 结论 绿脓杆菌的耐药性与其质粒密切相关。

Antibiotic suscptibility test and plasmid analysis of 159 strains P. aenuginosa in a children''''s Hospital

Objectives To search for the relationship between drug resistance and the plasmids of P. acruginosain a children's hospital. Methods Fifty-nine, 42 and 58 strains P. aeruginosa were collected from the burn ward, PICU andordinary wards respectively. There were 87 strains carrying p1asmids (Observation group). Fifty threestrains contained no plasmids (Control group). One hundred fifty nine isolater were tested with microdi-lution method to measure their susceptibility to 13 antibiotics. A modification of Birnboin method was usedto extra et plasmids of 140 isolates. Results 94.5% strains of P. aeruginosa were sensitive to amikacin and ceftazidime.Their MIC 90 wereall 16 mg/L, Only 23.3% isolates were susceptible to gentamicin. Thore strains isolated from the burnward and PICU had a higher rate of antibiotic resistance to ceftazidime, aztrconam, ceftriaxone, carbeni-cillin, cefotaxime and gentamicin than those isolates from ordinary wards. Plasmids were present in 62.1%(87/140) of isolates, while 37.9% (53/140)strains contained no plasmids. The rates of antibiotic resistanceto gentamicin, cefotaxime, carbenicillin and ceftriaxone were significantly higher in plasmid carrying strai-ns than those strains without plasmids. Conclusion Drug resistance of P. aeruginosa is closely related to their plasmids.