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目的分析临床分离的铜绿假单胞菌在多药耐药肺结核患者中的耐药特征及对亚胺培南的耐药机制。方法应用VITEK-32全自动微生物鉴定系统进行鉴定和药敏分析,对医院2006年1月-2007年10月93例多药耐药肺结核患者合并铜绿假单胞菌感染的临床资料进行回顾性分析。结果93株铜绿假单胞菌对碳青酶烯类、β-内酰胺酶抑制剂、氨基糖苷类、四代头孢菌素、喹诺酮类敏感率分别为87.2%、57.1%~85.3%、53.7%~75.0%、50.30%、64.1%~70.3%;而对二、三代头孢菌素、呋喃类、磺胺类的耐药率分别为59.5%~82.5%、87.0%、83.8%。结论多药耐药肺结核合并铜绿假单胞菌感染应予高度重视,治疗上减少酶抑制剂的使用,尤其是对重症多药耐药肺结核患者,避免诱导剂的产生,防止质粒传播和交叉感染。
Objective To analyze the drug resistance of clinical isolates of Pseudomonas aeruginosa in multidrug-resistant pulmonary tuberculosis patients and the mechanism of resistance to imipenem. Methods VITEK-32 automatic microbial identification system for identification and drug susceptibility analysis of the hospital from January 2006 -2007 in October 93 cases of multi-drug resistant pulmonary tuberculosis patients with Pseudomonas aeruginosa clinical data were retrospectively analyzed . Results The sensitivity rates of 93 Pseudomonas aeruginosa to carbapenems, β-lactamase inhibitors, aminoglycosides, cephalosporins and quinolones were 87.2%, 57.1% -85.3%, 53.7% ~ 75.0%, 50.30%, 64.1% ~ 70.3%, respectively. The resistance rates to second- and third-generation cephalosporins, furans and sulfonamides were 59.5% -82.5%, 87.0% and 83.8%, respectively. Conclusions Multidrug-resistant pulmonary tuberculosis combined with Pseudomonas aeruginosa infection should be highly valued, and the use of enzyme inhibitors should be reduced in treatment, especially in patients with severe multidrug-resistant pulmonary tuberculosis, avoid the induction of agents and prevent the spread of plasmid and cross-infection .