论文部分内容阅读
目的主要研究呼吸道感染标本中，铜绿假单胞菌对过去和现在常用的１２种抗生素的耐药性和产β－内酰胺酶菌株的首选药物治疗。方法标本获得纯培养后用ＶＩＴＥＫ－ＡＭＳ微生物自动分析仪鉴定到种，药物敏感试验采用Ｋ－Ｂ纸片法按ＮＣＣＬＳ规定的标准进行。结果引起呼吸道感染的５８株铜绿假单胞菌对１２种抗生素的平均耐药率为４７．６％，对舒普深、奥复兴、泰能的耐药率最高在１２．１％以下，而对氧哌嗪青霉素、头孢塞肟钠、特美丁的耐药率最低在６２．４％以上，５重以上耐药菌占７０．７％。５８株菌中产β－内酰胺酶的菌株占６３．８％，产酶菌对舒普深、奥复兴、泰能的耐药率在１８．９％以下，对头孢三嗪、氧哌嗪青霉素、头孢塞肟钠、特美丁的耐药率在６８．４％以上，５重以上耐药菌占８３．８％。结论高度怀疑由铜绿假单胞菌引起的呼吸道感染在未获得细菌药敏结果以前，应最好选择含酶抑制剂抗生素舒普深或奥复兴配以庆大霉素或丁胺卡那治疗；对产酶菌应首选舒普深、奥复兴或泰能治疗；对非产酶菌可选用第三代头孢菌素先锋必或复达欣并配以庆大霉素、妥布霉素或丁胺卡那等一般抗生素治疗。
Objective To study the resistance of Pseudomonas aeruginosa to 12 antibiotics commonly used in the past and present and the first choice of drug therapy for producing β-lactamase strains in respiratory tract specimens. Specimens were purely cultured and identified by VITEK-AMS automatic analyzer. Drug susceptibility testing was performed according to the standard of NCCLS by K-B method. Results 58 strains of Pseudomonas aeruginosa that caused respiratory tract infection had an average resistance rate of 47.6% to 12 antibiotics, and the highest rate of resistance to Shu-shang-shen, Ao-fu-xing and Tainun was below 12.1% The lowest rate of drug resistance to piperacillin, cephalosporin oxime and termetin was above 62.4%, and the resistant strains with 5 or more were 70.7%. Among 58 strains, β-lactamase producing strains accounted for 63.8%. The resistance rate of the producing strains to Schipper’s deep, Aoxingxing and Tainun was below 18.9% , Ceftazidime sodium and temephin were more than 68.4% and 83.8% were more than 5%. Conclusions It is highly suspected that respiratory infections caused by Pseudomonas aeruginosa should be treated with gentamicin or amikacin with schlumpurone or amoxicillin, an inhibitor of antibiotics, before the bacterial susceptibility results are obtained. The enzyme-producing bacteria should be preferred Shumu deep, Austrian rehabilitation or Thai can be treated; non-producing enzyme can be used third-generation cephalosporins Pioneer or Fuxing together with gentamicin, tobramycin or Ding Amikacin and other general antibiotic treatment.