摘要
目的研究烧伤中心广泛应用第三代头孢菌素背景下细菌耐药性。方法采用纸片扩散法。结果 259株革兰氏阴性杆菌对头孢噻肟、头孢曲松、头孢哌酮和头孢他啶全部耐药的菌株占31％,头孢哌酮/舒巴坦可使52％耐药菌株恢复敏感性,伊米配能和环丙沙星对铜绿假单胞菌、无硝不动杆菌、肠杆菌科耐药率分别为23.8％和51.2％,28.6％和21.4％,9.9％和20.4％。MRSA对伊米配能和环丙沙星耐药率分别为26.9％和73％,未发现去甲万古霉素耐药菌株。粪肠球菌对去甲万古霉素耐药率为2.7％。结论革兰氏阴性杆菌对第三代头孢菌素耐药机理除质粒介导的超广谱β-内酰胺酶外,部分菌株可能产生染色体介导的Ⅰ型β-内酰胺酶。
Objective To investigate bacterial resistance to antimicrobial agents in the back- ground of extensive employment of third-generation cephalosporins in the treatment of burn infection. Methods Bacterial susceptibility testing was carried out using Kirby-Bauer method. Results Out of 259 Gram negative bacilli isolates, 31% of these strains were all resistant to cefotaxime, cefotriaxone, ce- foperazone and ceftazidime. In vitro test, susceptibility of 52% third-generation cephlosporins resistant strains were restored by cefoperazone/sulbactum. 23.8% of P. aeruginosa were resistant to imipenem, 51. 2% to ciprofloxacin. 28. 6% of A. anitratum were resistant to imipenem, 21.4% to ciprofloxacin. 9.9% of enterobacteriaceae were resistant to imipenem, 20.4% to ciprofloxacin. 26.9% of MRSA were resistant to imipenem, 73% to ciprofloxacin. No norvancomycin resistance was detected. 2.7% of E. fae- calis were resistant to norvancomycin. Conclusion It is likely that the observed resistance to third-gen- eration cephalosporins may be partially due to chromosome-mediated type-1 β-lactamase.
