耐亚胺培南铜绿假单胞菌产金属酶及耐药监测

目的了解耐亚胺培南铜绿假单胞菌（Imipenem resistant Pseudomonas aeruginosa，IRPA）在我院的感染现状、产金属酶情况及其对临床常用抗茵药物的耐药监测，以指导临床更有效地使用抗生素。方法用法国梅里埃公司的VITEK．32全自动细菌鉴定与药敏系统检测其耐药性。用双纸片协同法检测铜绿假单胞茵产金属酶。结果分离的136株铜绿假单胞茵中耐亚胺培南的菌株有85株（占62．5％），其中产金属酶的有22株（占16．2％）；耐亚胺培南铜绿假单胞菌主要分布于重症监护病房（ICU）、干部病房、呼吸内科、脑外科；IRPA与亚胺培南敏感铜绿假单胞茵（Imipenem susceptible Pseudomonas aeruginosa，ISPA）耐药性有明显差异。结论IRPA对抗茵药物的耐药率明显高于ISPA且呈多重耐药，产金属酶是铜绿假单胞菌耐亚胺培南的主要机制之一。加强监控和优化使用抗生素，控制IRPA在院内的流行。

Condition of Imipenem Resistant Pseudomonas Aeruginosa Producing Metalloenzyme and Drug Resistance Monitoring

Objective To investigate the infection status, strains producing metalloenzyme, and resistance to clinical antibacte- rials of Imipenem resistant Pseudomonas aeruginosa （IRPA） in our hospital, and guide the clinical use of antibiotics more effec- tively. Methods We used VITEK-32 from France＇ s Merieux, an automatic identification of bacteria and drug sensitivity system, to detect its drug resistance. Meanwhile, we used two-disc synergy test to detect Pseudomonas aeruginosa produce metalloenzyme. Results Imipenem-resistant strains were 85 of 136 Pseudomonas aeruginosa, accounting for 62.5% （85/136） , in which 22 pro- ducing metalloenzyme, accounting for 16.2% （22/136）. IRPA were mainly distributed in the intensive care unit （ICU）, cadre wards, respiratory medicine, and brain surgery. There were significant differences in resistance between IRPA and Imipenem sus- ceptible Pseudomonas aeruginosa（ISPA）. Conclusion The rate of anti-bacterial drug resistance of IRPA was significantly higher than that of ISPA and IRPA presented multi-drug resistant. Producing metalloenzyme is one of the main mechanisms of Pseudo- monas aeruginosa resistant to Imipenem. We should strengthen the monitoring and optimize the use of antibiotics to control the IR- PA＇s propagation in hospitals.