|本期目录/Table of Contents|

[1]叶 明,杨喜民,王 刚,等.耐碳青霉烯类铜绿假单胞菌的产酶及联合药敏试验[摘要][J].医学研究与战创伤救治(原医学研究生学报),2011,13(02):135-137.
　YE Ming,YANG Xi-min,WANG Gang,et al.The analysis of zymogenic state against Carbapenems-resistant Pseudomonas aeruginosa using a susceptibility test[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(02):135-137.
点击复制

耐碳青霉烯类铜绿假单胞菌的产酶及联合药敏试验 [摘要] ()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第13卷
期数:
2011年02期
页码:
135-137
栏目:
出版日期:
2011-03-20

文章信息/Info

Title:
The analysis of zymogenic state against Carbapenems-resistant Pseudomonas aeruginosa using a susceptibility test
文章编号:
1672-271X(2011)02-0135-03
作者:
叶 明; 杨喜民; 王 刚; 雷光文
721004 陕西宝鸡，解放军第三医院检验科
Author(s):
YE Ming;  YANG Xi-min;  WANG Gang;  LEI Guang-wen
The Third Hospital of Peoples Liberation Army, Baoji, Shanxi 721004, China
关键词:
耐碳青霉烯类铜绿假单胞菌; 抗生素; 金属β-内酰胺酶; AmpC酶; 最低抑菌浓度; 联合用药
Keywords:
CR-PA;  antimicrobial agent;  metallo-β-lactamases;  AmpC;  minimum inhibiting concentration(MIC);  combining-using drug
分类号:
R978.1
DOI:
-
文献标志码:
A
摘要:
目的 研究耐碳青霉烯类铜绿假单胞菌(CR-PA)的产酶现状和抗菌药物的体外联合抗菌活性，为治疗CR-PA感染提供合理用药的实验依据。方法 常规培养分离细菌，应用VITEK-Ⅱ全自动细菌分析仪鉴定细菌。常规药敏试验采用K-B纸片法，MIC测定采用琼脂平板倍比稀释法，按CLSI规定标准进行。结果 从感染的标本中分离出190株铜绿假单胞菌， CR-PA占9.5%，均来自呼吸道标本。其中有10株同时产金属β-内酰胺酶(MBLs)、AmpC酶，4株仅产MBLs。头孢吡肟、头孢派酮/舒巴坦、亚胺培南与阿米卡星的协同率分别为33.3%、61.1%、27.8%。结论 CR-PA主要来源于呼吸道标本，其产酶率高，耐药性严重。建议临床对CR-PA引起的感染应使用含酶抑制剂复合药物(如哌拉西林/他唑巴坦、头孢派酮/舒巴坦)联合阿米卡星来治疗。
Abstract:
Objective To analyze the zymogenic state and antimicrobial agent combination activity in vitro test of Carbapenems-resistant Pseudomonas aeruginosa (CR-PA), in order to provide laboratory data for clinical treatment. Methods All strains were isolated and identified by routine procedure and VITEK-Compact 2 automatic bacterial identification system. Routine antimicrobial susceptibility tests were performed with K-B method and MICs were detected with agar dilution method according to CLSI. Results There were 190 strains Pseudomonas aeruginosa isolated from clinical infectious specimen. CR-PA was 9.47% in all of that came from respiratory tract specimen. There were 10 strains produced Metallo-β-lactmases and AmpC, 4 strains produced Metallo-β-lactmases. The synergy rate of Cefpirome, Cefoperazone/Sulbactam, Imipenem plus Amikaein were 33.3%, 61.1%, and 27.8% respectively. Conclusion CR-PA mostly came from respiratory tract specimen. The zymogenic rates and drug resistance of CR-PA were high, mostly due to multiplex drug-resistance mechanism. Clinical treatment should first select enzyme-inhibitory drugs (Piperacillin/Tazobactam or Cefoperazone/ sulbactam) combined with Amikacin against CR-PA.

参考文献/References:

[1]赵苏瑛,吴 倩,李克涓,等.耐碳青霉烯类铜绿假单胞菌金属酶的筛选及分型研究[J].中国感染与化疗杂志,2009,9(1): 48-51.
[2]CLSI.Performance Standards for Antimicrobial Susceptibility Testing; Nineteenth Informational Supplement [S].CLSI,2009(M100-S19):44-45.
[3]沈定霞,罗燕平,崔 岩,等.分离产金属β-内酰胺酶的铜绿假单胞菌[J].中华医院感染学杂志,2004,14(4): 86-88.
[4]褚海青,任胜祥,李惠萍.下呼吸道标本铜绿假单胞菌感染产AmpC 酶和ESBLS酶的研究[J].中国感染与化疗杂志,2006,6(1):22-26.
[5]田 磊，李 莉，张 蓓，等.阴沟肠杆菌AmpC酶与ESBLC酶的研究[J].中华医院感染学杂志，2009，19(15):1941-1943.
[6]黄支密,杨丽蓉,糜祖煌,等.亚胺培南耐药铜绿假单胞菌消毒剂及β内酰胺类抗生素耐药相关基因研究[J].东南国防医药, 2005,7(3):172-175.
[7]刘忆霜,肖春玲.细菌多重耐药外排泵抑制剂研究进展[J].中国抗生素杂志, 2007,32(4):211-215.
[8]陈建中,黄支密,仵 蕾,等.4种非发酵糖革兰阴性杆菌氨基糖苷类修饰酶基因研究[J].东南国防医药, 2007,9(3):161-164.
[9]徐俊芳,吴菊芳.多重耐药铜绿假单胞菌感染[J].中国感染与化疗杂志, 2007,7(20):141-144.

相似文献/References:

[1]杨 燕,孙长贵,陈 坚,等.用改良Hodge试验检测产碳青霉烯酶肠杆菌科细菌[J].医学研究与战创伤救治(原医学研究生学报),2011,13(03):223.
　YANG Yan,SUN Chang-gui,CHEN Jian,et al.Detection of carbapenemase in isolates of Enterobacteriaceae by the modified Hodge test[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(02):223.
[2]陶瑛瑛,马爱华,倪江洪.夫西地酸钠的配伍禁忌及处理方法[J].医学研究与战创伤救治(原医学研究生学报),2010,12(03):257.
[3]韩清萍,刘秀娟,余燕燕.头孢菌素致尿毒症患者神经毒性36例分析及护理[J].医学研究与战创伤救治(原医学研究生学报),2010,12(03):266.
[4]郎根强,章益峰,褚 健,等.[1]庄颜峰，吕 琦，陈学明，等. 严重骨盆骨折的初期救治体会[J]. 中华创伤骨科杂志，2004,6(5):582-583.[J].医学研究与战创伤救治(原医学研究生学报),2009,11(06):493.
　LANG Gen-qiang,ZHANG Yi-feng,CHU Jian,et al.Treatment of chronic prostatitis with ectoshortwave, antibiotics and prostant[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(02):493.
[5]潘雪飞,杜 斌,范 群,等.综合分析药物性肝损伤4 076例[J].医学研究与战创伤救治(原医学研究生学报),2009,11(06):505.
　PAN Xue-fei,DU Bin,FAN Qun,et al.The statistic analysis of the 4 076 patients with drug induced liver injury[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(02):505.
[6]杨辛怡综述,季国忠审校.幽门螺杆菌感染的治疗方案[J].医学研究与战创伤救治(原医学研究生学报),2017,19(03):280.[doi:10.3969/j.issn.1672-271X.2017.03.015]

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2011-03-20