多药耐药鲍氏不动杆菌与铜绿假单胞菌对头孢哌酮/舒巴坦的敏感性研究

目的 比较多药耐药鲍氏不动杆菌与多药耐药铜绿假单胞菌产金属β-内酰胺酶的情况和对头孢哌酮/舒巴坦的耐药性,为临床治疗该细菌感染提供实验室依据.方法 用VITEK-32、GNS-132系统常规检测非重复鲍氏不动杆菌42株、铜绿假单胞菌95株,同时用Etest检测金属β-内酰胺酶,用纸片扩散法(K-B法)检测头孢哌酮/舒巴坦和多黏菌素E的药敏试验,分析二者不同耐药表型对头孢哌酮/舒巴坦的敏感性差异.结果 鲍氏不动杆菌、铜绿假单胞菌对亚胺培南耐药率分别为66.7%、31.6%;多药耐药鲍氏不动杆菌、铜绿假单胞菌均有较‘多产金属β-内酰胺酶株;头孢哌酮/舒巴坦耐对亚胺培南非产金属β-内酰胺酶的敏感性差异无统计学意义,头孢哌酮/舒巴坦对耐亚胺培南产金属β-内酰胺酶的敏感性差异有统计学意义(P<0.05).结论 多药耐药鲍氏不动杆菌对头孢哌酮/舒巴坦敏感性高于多药耐药铜绿假单胞菌,治疗耐亚胺堵南的多药耐药鲍氏不动杆菌可选用头孢哌酮/舒巴坦,治疗耐亚胺培南的多药耐药铜绿假单胞菌特别是MBLs应选用多黏菌素E或联合用药.

Susceptibility to Cefoperazone/sulbactam of Multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa

OBJECTIVE To detect metallo-β-lactamases(MBLs)produced by muhidrug-resistant Acinetobacter baumannii(MDR-AB)and muhidrug resistant Pseudomonas aeruginosa(MDR-PA)in our hospital and their resistance to cefoperazone/sulbactam.METHODS VITEK-32,GNS-132 system,routine test were used to detect non-duplicating A.baumannii(42 strains)and P.aeruginosa(95 strains),while Etest used to detect MBLs and K-B method to detect drug sensitivity to cefoperazone/sulbactam and polymyxin E.The sensitivity of two different drug-resistant phenotypes to cefoperazone/sulbactam was and analyzed.RESULTS The imipenem resistance rate of A.baumannii and P.aeruginosa was 66.7%and 31.6%,respectively.MRD-AB and MRD-PA had more MBLs strains.The sensitivity of imipenem-resistant van-producing MBLs strains to cefoperazone/sulbactam statistically was without significant difference,while that with MBLs was with significant difference(P<0.05).CONCLUSIONS The sensitivity to cefoperazone/sulbactam of MDR-AB is higher than that of MDR-PA.Cefoperazone/sulbactam can be choose to treat MDR-AB with imipenem resistance MDR-PA with imipenem resistance especially producing metallo β-lactamases,can be treated with polymyxin E or its combination.