耐碳青霉烯类铜绿假单胞菌的耐药性及分子流行病学研究

发布时间：2018-01-04 10:15

本文关键词：耐碳青霉烯类铜绿假单胞菌的耐药性及分子流行病学研究　出处：《中国感染与化疗杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的了解耐碳青霉烯类铜绿假单胞菌(CRPA)对抗菌药物的耐药性及分子生物学特征。方法收集2013年1-12月复旦大学附属华山医院住院患者临床分离的CRPA 104株,采用琼脂稀释法对菌株行药敏测定;脉冲场凝胶电泳(PFGE)行同源性分析。结果 104株CRPA对美罗培南、亚胺培南的耐药率分别为85.6%、98.1%,对阿米卡星、庆大霉素的耐药率分别为18.3%、40.4%,对头孢他啶和头孢吡肟的耐药率分别为26.9%和21.2%,对环丙沙星和左氧氟沙星的耐药率分别为44.2%和50.0%,对哌拉西林-他唑巴坦、头孢哌酮-舒巴坦和替卡西林-克拉维酸的耐药率分别为19.2%、26.9%和52.9%,对氨曲南耐药率为26.9%,对黏菌素耐药率最低,仅为5.8%。PFGE分析存在48个型别(3株未能分型),9个克隆。克隆A是主要流行株,占41.6%(42/101),科室主要集中在神经外科、老年科及综合病房,其次为克隆B,占5.9%(6/101)。结论医院内存在耐碳青霉烯类铜绿假单胞菌的多个克隆,应采取有效的感染控制手段,加强抗菌药物临床应用管理,延缓细菌耐药性产生并阻止耐药菌进一步播散。
[Abstract]:Objective to investigate the resistance to carbapenem Pseudomonas aeruginosa (CRPA). Methods the clinical isolates of CRPA from 2013 to 2013 in Huashan Hospital of Fudan University were collected. The drug sensitivity of the strain was determined by Agar dilution method. Results the resistance rates of 104 CRPA strains to meropenem and imipenem were 85.6 and 98.1, respectively. The resistance rates of gentamicin and ceftazidime to ceftazidime and cefepime were 18.3and 21.2%, respectively, and those to ceftazidime and cefepime were 26.9% and 21.2%, respectively. The resistance rates to ciprofloxacin and levofloxacin were 44.2% and 50.0, respectively, and piperacillin to tazobactam. The drug resistance rates of cefoperazone-sulbactam and ticarcillin clavulanic acid were 19.226.9% and 52.9%, respectively. The resistance rate of cefoperazone-sulbactam and ticacillin clavulanic acid were 26.9% and 26.9%, respectively. The resistance rate of cefoperazone-sulbactam and ticacillin clavulanic acid was the lowest. Only 5.8. PFGE analysis showed that 48 strains could not be genotyped, 9 clones. Clone A was the main epidemic strain, accounting for 41.6% 42 / 101). The departments were mainly concentrated in neurosurgery geriatrics and general wards followed by clone B (5.9 / 101). Conclusion there are several clones of carbapene-resistant Pseudomonas aeruginosa in hospitals. Effective infection control measures should be adopted to strengthen the management of clinical application of antimicrobial agents, to delay the production of bacterial drug resistance and to prevent the further spread of drug-resistant bacteria.
【作者单位】：复旦大学附属华山医院医院感染管理科;复旦大学附属华山医院抗生素研究所;
【分类号】：R446.5
【正文快照】： 作者单位:复旦大学附属华山医院医院感染管理科,上海200040;*抗生素研究所。袁莉莉,丁百兴*,沈震*,吴n\*,徐晓刚*,李光辉*铜绿假单胞菌广泛分布于自然界及健康人的皮肤、肠道和呼吸道等部位,为医院感染主要的条件致病菌之一。近年来,随着碳青霉烯类抗菌药物的广泛使用,该菌对

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