亚胺培南敏感铜绿假单胞菌的分离及耐药分析

目的了解亚胺培南敏感铜绿假单胞菌在我院的分离情况及其耐药性。方法对分离出的细菌采用常规鉴定或用MicroScan WalkAway96微生物分析系统进行鉴定,药敏试验采用K-B法,结果根据NCCLS/CLSI规定进行判断,用亚胺培南诱导铜绿假单胞产生诱导酶。结果200株对亚胺培南敏感的铜绿假单胞菌主要来源于痰及咽拭子标本,占70.5%,其次为各种脓液及分泌物,占22.5%。其科室分布以呼吸科、老年内科和骨科为主,分别为19.5%、19.0%和13.5%。亚胺培南敏感铜绿假单胞菌对美罗培南的敏感率最高,为94.0%,其次是头孢他啶、阿米卡星和哌拉西林/他唑巴坦,分别为87.5%、86.5%和80.5%,头孢哌酮/舒巴坦和氨曲南的中介率最高,分别为20.0%和17.0%。亚胺培南敏感菌株诱导酶的产酶率为27.5%。结论亚胺培南敏感的铜绿假单胞菌主要来源于呼吸内科和老年内科的呼吸道感染,其次是骨科的各种伤口感染,对所有抗生素的敏感率均比较高,亚胺培南是一种较强的诱导剂,可以使铜绿假单胞菌产生诱导耐药。

Isolation and Antimicrobial Susceptibility of Imipenem- susceptible Pseudomonas aeruginosa

Objective To study the isolation and antimicrobial susceptibility of imipenem-susceptible Pseudomonas aeruginosa in the Second Xiangya Hospital of Central South University.Methods The cultured bacteria were identified with routine methods or MicroScan WalkAway 96 system.The susceptibilities of the bacteria were detected by disk diffusion method and the results were confirmed with the rules of NCCLS/CLSI.The inducible enzymes were tested with imipenem-inducible assay.Results Among the 200 strains of imipenem-susceptible Pseudomonas aeruginosa,70.5% came from sputum or throat swabs,and 22.5% came from pus or secretion.The proportion of these strains from respiratory department was 19.5%,from geriatric department 19.0% and from orthopaedics department only 13.5%.The susceptibility rates of strains for meropenem,ceftazidime,amikacin,and piperacillin/tazobactam were 94.0%,87.5%,86.5%,and 80.5%,respectively.The intermediate rate for cefoperazone/sulbactam and aztreonam was 20.0% and 17.0%.The rate of strains producing inducible enzymes was 27.5%.Conclusions The strains of imipenem-susceptible Pseudomonas aeruginosa mainly come from respiratory tract infections and wound infections,and the susceptibility for most antibiotics is high.As a kind of strong derivant,imipenem can make Pseudomonas aeruginosa induce resistance.