【摘要】 目的了解我院鲍曼不动杆菌产β-内酰胺酶的现状及对临床常用12种抗菌药物的耐药性。方法对我院临床感染标本分离的120株鲍曼不动杆菌使用Cefinase纸片法进行β-内酰胺酶初筛检测;采用改良三维试验大平皿法进行β-内酰胺酶分型;药敏试验采用琼脂平板倍比稀释法测定MIC,按CLSI/NCCLS标准进行。结果除亚胺培南外,120株鲍曼不动杆菌对其余11种抗菌药物的耐药率均超过50%。Cefinase纸片法检测到114株产β-内酰胺酶(95%),其中63株(55.24%)经改良三维试验大平皿法进行酶分型。在63株鲍曼不动杆菌中,单产碳青霉烯酶4株(3.51%)、产ESBLs15株(13.16%)、产AmpC酶5株(4.39%)及产耐酶抑制剂β-内酰胺酶(IRTs)18株(15.78%);同时产碳青霉烯酶和ESBLs的有5株(4.39%);产AmpC酶和ESBLs的分别有9株(7.89%),同时产碳青霉烯酶和IRTs的有7株(6.14%)。结论我院鲍曼不动杆菌对临床常用抗菌药物耐药性较高,可能与产多型β-内酰胺酶有关。三维试验结果以产ESBLs最多且复杂,其次是IRTs。本研究建立的改良三维试验大平皿法能在同一平板上进行几种常见β-内酰胺酶的筛选分型,取得了很好的效果。更多还原

【Abstract】 Objective To understand the present status of β-lactamases and resistance to 12 common antimicrobial agents in clinical isolates of Acinetobacter baumannii.Methods The β-lactamases production was detected early by the cefinase slip method to 120 Acinetobacter baumannii strains from clinical specimens in our hospital.The types of β-lactamases production were distinguished by a three-dimensional modified test using a big agar plates in those isolates.The MICs of 12 common antimicrobial agents to these isolates were determined by 2-fold agar dilution method followed by CLSI recommendations.Results Except IMP,the resistant rates of 120 isolates to 11 common antimicrobial agents were more than 50%.There were 114 strains producing β-lactamases(95%),in which,63 isolates were typed by the three-dimensional modified test using a big agar plates,there were 4 strains(3.51%),15 strains(13.16%),5 strains(4.39%) and 18 strains(15.78%) producing carbapenemases,ESBLs,AmpC enzyme,and IRTs,respectively;there were 5 strains(4.39%),9 strains(7.89%) and 7 strains(6.14%) producing carbapenemases plus ESBLs,AmpC,ESBLs,and IRTs,respectively.Conclusion Results showed that the three-dimensional modified test with a big agar plates was an effective approach for the detection and differentiation of various multiplex types of β-lactamases.更多还原