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1.
目的比较不同部位培养出的铜绿假单胞菌耐药性,为临床控制和治疗铜绿假单胞菌感染提供依据。方法收集住院患者不同标本中分离的铜绿假单胞菌进行鉴定和药敏试验。结果分离率以痰标本中最高,占57.67%;伤口分泌物次之占30.69%。科室分布以ICU(38.1%)、神经外科(15.34%)和烧伤科(14.81%)最多见。同一种抗菌药物对不同标本分离的铜绿假单胞菌显示出不同敏感性,痰标本中铜绿假单胞菌对常用抗菌药物耐药率较伤口分泌物标本中高,除头孢哌酮/舒巴坦、氨苄西林/舒巴坦和复方新诺明外,对其他常用的12种抗菌药物耐药率比较差异有统计学意义(P〈0.05)。结论不同标本分离的铜绿假单胞菌对抗菌药物耐药性存在差异,临床经验用药时应区别对待不同部位铜绿假单胞菌的感染。  相似文献   

2.
目的 监测湖北地区铜绿假单胞菌对亚胺培南-西司他丁的耐药性及流行病学研究。方法 对1999~2 0 0 2年15所大型综合医院感染标本中分离的3772株铜绿假单胞菌作回顾性分析。结果 铜绿假单胞菌对亚胺培养-西司他丁的耐药率分别为14 .4 9%、9.5 1%、10 .38%和13.15 % ,不同年度耐药率统计学差异有非常显著性( P<0 .0 1)。同时2 0 0 0~2 0 0 2年的耐药率,呈明显上升趋势。耐亚胺培南-西司他丁铜绿假单胞菌在各病区的分布以外科病房、内科病房和ICU病房为主。ICU病房的耐药率呈逐年升高,耐亚胺培南-西司他丁铜绿假单胞菌的检出率从1999年的10 .2 %升至2 0 0 2年的2 9.7% ,各年度差异有非常显著性( P<0 .0 0 5 )。标本分布以痰液分离率最高,伤口分泌物次之,尿液占第3位。结论 该地区铜绿假单胞菌耐亚胺培南-西司他丁,有逐年增长趋势;要重视对铜绿假单胞菌耐药性的研究,为临床治疗提供科学依据  相似文献   

3.
目的调查分析象山县中医医院铜绿假单胞菌的临床分布及药敏情况,为临床合理选用抗生素提供可靠的依据。方法采集疑似患者的标本,进行分离、培养与鉴定。采用自动微生物鉴定/药敏分析仪进行鉴定及药敏试验,对2012年7月至2013年10月分离出的126株铜绿假单胞菌(包括21株黏液型铜绿假单胞菌)的分布及耐药性进行回顾性分析。结果126株铜绿假单胞菌临床主要分布情况:痰占80.2%,尿液占11.1%,脓液占7.1%,以呼吸道感染为主。对铜绿假单胞菌保持活性较强同时耐药率〈20%的抗生素有阿米卡星、妥布霉素、亚胺培南、哌拉西林/他唑巴坦,其中碳青霉烯类耐药率升至5%,原来被认为抗铜绿假单胞菌较为有效的喹诺酮类抗生素的耐药率也有了很大提升,左氧氟沙星耐药率升至33%。黏液型铜绿假单胞菌的体外抗菌药物敏感试验耐药性较弱,且明显弱于非黏液型铜绿假单胞菌的耐药性。结论铜绿假单胞菌为医院呼吸道感染的常见致病菌,对多种抗菌药物呈不同程度耐药。加强动态监测,合理使用抗菌药物,对铜绿假单胞菌感染的预防和药物治疗具有重要指导意义。  相似文献   

4.
目的了解铜绿假单胞菌在儿童重症监护病房(ICU)与普通病房的分布及耐药性差异,为临床合理、有效的治疗提供依据。方法分析重庆医科大学附属儿童医院2013年1月至2013年12月ICU及普通病房铜绿假单胞菌培养阳性患儿的年龄分布、菌株来源、抗菌药物的耐药性。结果 ICU和普通病房分别分离出82株和429株铜绿假单胞菌,年龄均小于2岁(70.73%和69.23%),以痰标本来源(80.49%和64.80%)为主。ICU分离的铜绿假单胞菌对氟喹诺酮类药物的耐药率低于普通病房,对其余测试药物的耐药率均高于普通病房。ICU分离的铜绿假单胞菌中多重耐药菌55株(67.07%),泛耐药菌44株(53.66%),均明显高于普通病房(26.81%,3.26%)(P〈0.05)。结论铜绿假单胞菌是ICU常见的病原菌,具有多重耐药特性,加强耐药性监测,控制医院内感染,对临床医生选用有效的抗生素具有十分重要的意义。  相似文献   

5.
目的:了解我院骨伤患者耐亚胺培南铜绿假单胞菌的感染狀況及耐药性特点,为临床医师合理用药提供参考方法:回顾性分析2010年1月至2013年12月分离到的250株耐亚胺培南铜绿假单胞菌,其菌种鉴定及药敏采用美国BD Phoenix100結全自动细菌鉴定及药敏分析系统进行。果:四年间我院耐亚胺培南铜绿假单胞菌感染率不断提高,平均占28.5%。主要来源于分泌物标本,占64.0%。耐亚胺培南铜绿假单胞菌对哌拉西林/他唑巴坦、阿米卡星、头孢他啶耐药率较低分别为33.6%、35.2%、48.4%,可作为临床用药的参考。结论我院耐耐亚胺培南铜绿假单胞菌感染情況较严重,应根据药敏试验结果,指导临床合理使用亚胺培南,控制耐亚胺培南铜绿假单胞菌的院內流行传播。  相似文献   

6.
摘要:目的 分析铜绿假单胞菌的分布和耐药性变化,为临床防治铜绿假单胞菌感染提供依据。方法 收集成都大学附属医院2014—2016年所分离的铜绿假单胞菌,采用VITEK 2-Compact全自动细菌鉴定系统进行鉴定和药敏试验,采用WHONET 5.6软件对数据进行分析。结果 3年间共分离出1 945株铜绿假单胞菌,多重耐药铜绿假单胞菌分离率为34.2%(666/1945)。标本来源以呼吸道为主,占82.2%(1598/1945)。科室分布以呼吸内科最多,ICU其次。铜绿假单胞菌对头孢曲松和头孢噻肟的耐药率最高,均>57.0%;对阿米卡星耐药率最低,为2.0%。3年来铜绿假单胞菌对17种抗生素的耐药率呈整体上升的趋势。结论 铜绿假单胞菌对头孢曲松、头孢噻肟、亚胺培南耐药率较高,对阿米卡星耐药率较低。铜绿假单胞菌的耐药率呈整体上升的趋势,应重视细菌耐药性的监测,以延缓耐药性产生、促进临床合理用药。  相似文献   

7.
探讨耐亚胺培南铜绿假单胞菌的耐药性及其产超广谱β-内酰胺酶基因型。收集2011年7月至2013年12月上海市中医药大学附属曙光医院临床分离的铜绿假单胞菌共1 125株,筛选亚胺培南耐药株,常规纸片法检测其耐药性,并用E-test检测金属β-内酰胺酶(MBL),采用PCR法检测耐药基因型。结果显示,1 125株铜绿假单胞菌中耐亚胺培南铜绿假单胞菌共计617株,占54.8%;亚胺培南敏感铜绿假单胞菌共计508株,占45.2%。617株亚胺培南耐药铜绿假单胞菌100%为多重耐药,而亚胺培南敏感铜绿假单胞菌的多重耐药率仅为13.78%,明显较前者低(χ2=871.15,P<0.05);亚胺培南耐药的铜绿假单胞菌中MBL表型阳性共126株,阳性率为15.4%,94株(74.60%)表现为VIM-2阳性,10株(7.94%)表现为IMP-1阳性,1株检出OXA-10,〖WTBZ〗且该例菌株同时表达VIM-2。临床分离的耐亚胺培南的铜绿假单胞菌多为多重耐药,其产MBL的主要基因型是VIM-2。  相似文献   

8.
目的了解铜绿假单胞菌(PA)在医院内感染的分布特点及其耐药性,指导临床合理用药,降低医院感染率。方法回顾分析2005年1月至2008年11月我院临床分离的铜绿假单胞菌152株,按WHO推荐的NC-CLS标准方法(K—B法)进行药敏试验,分析菌株的临床分布特征及体外药敏结果。结果铜绿假单胞菌在临床上主要以呼吸道感染为主。在17种临床常用抗生素中,多表现为多重耐药。美洛培南、亚胺培南及左旋氧氟沙星抗PA效果最好,耐药率分别只有14.47%、14.47和5.26%。结论多重耐药铜绿假单胞菌在临床广泛存在,应当根据临床体外药敏结果合理选择抗菌药物进行治疗,以取得良好临床效果并减少耐药菌产生;同时规范院内感染控制措施,减少耐药菌株的播散。  相似文献   

9.
了解宜昌市铜绿假单胞菌(Pseudomonas aeruginosa)临床分离株的耐药现状。宜昌市城区5所医院临床分离的铜绿假单胞菌菌株,用K-B法作药敏试验,并根据统计其耐药情况及耐药表型(模式)分析可能存在的耐药机制。临床分离的铜绿假单胞菌共1 575株,耐药率依次为阿米卡星7.1%、美罗培南17.2%、头孢吡肟20.4%、头孢哌酮/舒巴坦21.0%、哌拉西林/他唑巴坦22.5%、环丙沙星23.1%、庆大霉素23.4%、头孢他啶25.0%、亚胺培南25.2%、哌拉西林30.4%、氨曲南34.5%、复方新诺明59.0%、米诺环素75.6%。多重耐药(MDR)和泛耐药(PDR)株分别占41.5%和0.17%。对各种抗假单胞菌药物分别耐药的菌株仍有13%~25.7%对阿米卡星敏感,提示在严重铜绿假单胞菌感染患者的治疗中,β内酰胺类抗假单胞菌药加氨基糖苷类仍是一个很好的联合用药组合。细菌耐药性仍呈增长趋势,临床上感染多重耐药和泛耐药的铜绿假单胞菌的治疗仍很棘手,应合理使用抗生素,尽量延缓耐药菌株的出现。  相似文献   

10.
目的了解广州地区铜绿假单胞菌(PA)3种主要β-内酰胺酶(金属β-内酰胺酶、超广谱β-内酰胺酶和AmpC酶)的产生情况和血清型分布,观察这些铜绿假单胞菌的耐药差别.方法用法国生物梅里埃公司的VITEK-2细菌鉴定与药敏系统进行217株铜绿假单胞菌的鉴定与药敏,对可疑产金属β-内酰胺酶、超广谱β-内酰胺酶、AmpC酶的菌株,用双纸片协同试验和头孢西丁三维试验进行3种酶的表型确证,同时采用玻片凝集试验对这些菌进行血清分型.结果217株铜绿假单胞菌的β-内酰胺酶产酶率为20.7%(45/217),其中产金属β-内酰胺酶的有26株,占12.0%(26/217),产AmpC酶的有11株,占5.1%(11/217),产超广谱β-内酰胺酶的有8株,占3.7%(8/217);对氨曲南、头孢吡肟、头孢他啶、环丙沙星、亚胺培南、左旋氧氟沙星、哌拉西林、哌拉西林/他唑巴坦、替卡西林/棒酸和美洛培南这些临床常用抗生素,产酶菌较不产酶菌敏感性明显降低(P均小于0.05);217株铜绿假单胞菌的血清分型以G型为主,占39.6%(86/217),其次为L型,占19.8%(43/217);产酶菌株的血清型以B和L型为主.结论广州地区引起临床感染的铜绿假单胞菌产生的β-内酰胺酶以金属酶最常见,其次为AmpC酶和超广谱β-内酰胺酶;产酶株对临床常用抗生素敏感性降低;广州地区铜绿假单胞菌的血清型以G型为主,产酶菌株以L和B型为主,临床上治疗铜绿假单胞菌引起的感染应根据实验室的药敏结果选择抗生素.  相似文献   

11.
Nosocomial wound infections by antibiotic-resistant Pseudomonas aeruginosa strains have increasing importance in hospitals. Outer membrane proteins of the bacterium have strong influence on its resistance to antibiotics. In the current study, a parallel proteomic approach was applied to analysis of sarcosine-insoluble outer membrane fraction of P. aeruginosa responding to ampicilin, kanamycin and tetracycline resistances. Eleven differential proteins with 15 spots were determined and then identified by MALDI-TOF/MS, in which four with increased OprF, MexA, OmpH, and decreased hypothetical protein (NCBI No. 15599856), six with increased OprF, OmpH, hypothetical protein (NCBI No. 15599183) and decreased OprG, MexA, conserved hypothetical protein (NCBI No. 15600371), and eight with increased OprF, MexA, OprL, probable Omp (NCBI No. 15599856), probable secretion protein (NCBI No. 15600167), OprD and decreased OprG, conserved hypothetical protein (NCBI No. 15600371) responded to ampicilin, kanamycin, and tetracycline resistances, respectively. With the exception of OprF, the other differential proteins did not show the same behaviors against the three antibiotic resistances. Compared with our previous report on E. coli Omps responding to ampicilin and tetracycline resistances, which was only a protein difference in quality between the two antibiotics, P. aeruginosa showed significant diversity against the three antibiotics. Our findings might provide valuable data for an understanding of antibiotic-resistant difference between different species of bacteria. Meanwhile, these proteins shared by different bacteria or a bacterium against different antibiotics may provide universal targets for the development of new drugs that control antibiotic-resistant bacteria.  相似文献   

12.
目的 了解重症监护病房(ICU)耐亚胺培南铜绿假单胞菌(IRPA)的金属β-内酰胺酶(MBLs)的产生情况及其耐药特性,为临床抗感染治疗提供依据.方法 对深圳市观澜人民医院2010年1月至2011年12月ICU分离的587株铜绿假单胞菌(PAE),用双纸片协同试验检测MBLs产生情况,用VITEK 2 compact全自动微生物分析系统检测其对17种抗生素的耐药性.结果 在587株PAE中,IRPA 127株,占21.6%;IRPA对其中7种抗生素为全耐药,对其余10种抗生素的耐药率也在40%以上;IRPA组及亚胺培南敏感铜绿假单胞菌(ISPA)组两组间对常用抗生素的耐药率比较,除AMP、CZO、FTN、SXT、SAM及CTT外,两组其余抗生素的耐药率差异均有统计学意义(P<0.01);在127株IRPA中,产MBLs 45株,产酶率为35.4%.结论 IRPA的检出率较高,多药耐药现象较严重,产MBLs是PAE对IPM及头孢类抗菌药物耐药的主要原因之一,应参考实验室的药敏结果,合理选用抗菌药物.  相似文献   

13.
More than 750 isolates of faecal coliforms (>200 strains), enterococci (>200 strains) and pseudomonads (>340 strains) from three wastewater treatment plants (WTPs) and from four groundwater wells in the vicinity of leaking sewers were tested for resistance against 14 antibiotics. Most, or at least some, strains of the three bacterial groups, isolated from raw or treated sewage of the three WTPs, were resistant against penicillin G, ampicillin, vancomycin, erythromycin, triple sulfa and trimethoprim/sulfamethoxazole (SXT). Only a few strains of pseudomonads or faecal coliforms were resistant against some of the other tested antibiotics. The antibiotic resistances of pseudomonads, faecal coliforms and enterococci from groundwater varied to a higher extent. In contrast to the faecal coliforms and enterococci, most pseudomonads from all groundwater samples, including those from non-polluted groundwater, were additionally resistant against chloramphenicol and SXT. Pseudomonads from sewage and groundwater had more multiple antibiotic resistances than the faecal coliforms or the enterococci, and many pseudomonads from groundwater were resistant to more antibiotics than those from sewage. The pseudomonads from non-polluted groundwater were the most resistant isolates of all. The few surviving faecal coliforms in groundwater seemed to gain multiple antibiotic resistances, whereas the enterococci lost antibiotic resistances. Pseudomonads, and presumably, other autochthonous soil or groundwater bacteria, such as antibiotic-producing Actinomyces sp., seem to contribute significantly to the gene pool for acquisition of resistances against antibiotics in these environments.  相似文献   

14.
应用K-B氏纸片扩散法测定了5年间本院分离的4种2451株革兰氏阴性菌大肠埃希氏菌、沙雷氏菌、铜绿假单胞菌、醋酸钙不动杆菌对临床常用11~14种抗生素的敏感性,4种菌对受试抗菌素均有不同程度的耐药性,且对多种抗菌素的耐药率有逐年增加的趋势,表明细菌耐药性在医院内感染中有着越来越重要的作用。  相似文献   

15.
AIMS: To produce strains of antimicrobial-resistant Pseudomonas aeruginosa via adaptation to benzalkonium chloride, amikacin and tobramycin and to then examine the incidence, or otherwise, of cross-resistance between antibiotics and between antibiotics and benzalkonium chloride. METHODS AND RESULTS: Adaptation was obtained by progressive subculturing in subinhibitory concentrations of the antimicrobials. Pseudomonas aeruginosa NCIMB 10421 adapted to grow in high concentrations of benzalkonium chloride (BC) had lower MIC to antibiotics than the wild type, whereas Ps. aeruginosa adapted to grow in antibiotics had greater MIC to benzalkonium by a small degree. CONCLUSIONS: Adaptive resistance to BC of Ps. aeruginosa generally produced cultures with a decrease in resistance to several antibiotics. Adaptive resistance to the aminoglycosides Ak and Tm produced a low-level increase in tolerance to BC. The adaptive mechanisms of resistance appear to be different for the different types of antimicrobials used. SIGNIFICANCE AND IMPACT OF THE STUDY: The relationships between biocide and antibiotic resistance are complex. It appears, from this study, that an organism resistant to a common biocide can become sensitive to antibiotics, but the converse was not true. Could this observation be used in a strategy to alleviate antibiotic resistance?  相似文献   

16.
AIMS: To determine the prevalence of Salmonella enterica serovars in chicken carcasses in slaughterhouses in Spain and to examine genotypic relations among these serovars. METHODS AND RESULTS: A total of 336 chicken carcasses were collected from six slaughterhouses in Northwestern Spain. Salmonellae were isolated (ISO-6579-1993), serotyped, phage-typed, ribotyped and antibiotyped against 20 antibiotics. Salmonella strains were detected in 60 (17.9%) carcasses. Isolates belonged to nine different serotypes, with Salm. Enteritidis being the most common. Three strains (5%) were resistant to one antibiotic and 24 (40%) were multi-resistant (to more than one antibiotic). The most frequently encountered resistances were to sulphamides, fluoroquinolones and tetracycline. Ribotyping was able to differentiate isolates of the same serotype and phage type. CONCLUSIONS: The Salmonella serotypes and phage types detected are among those most frequently associated with human diseases in Spain. The large percentage of antimicrobial resistant strains is a matter for concern. A high genetic relationship between strains from different slaughterhouses was found. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides detailed information about Salmonella isolates from poultry in Spain. It emphasizes the importance of controlling this pathogen in poultry products, and suggests the need for more prudent use of antibiotics.  相似文献   

17.
Microorganisms are responsible for multiple antibiotic resistances that have been associated with resistance/tolerance to heavy metals, with consequences to public health. Many genes conferring these resistances are located on mobile genetic elements, easily exchanged among phylogenetically distant bacteria. The objective of the present work was to isolate arsenic-, antimonite-, and antibiotic-resistant strains and to determine the existence of plasmids harboring antibiotic/arsenic/antimonite resistance traits in phenotypically resistant strains, in a nonanthropogenically impacted environment. The hydrothermal Lucky Strike field in the Azores archipelago (North Atlantic, between 11°N and 38°N), at the Mid-Atlantic Ridge, protected under the OSPAR Convention, was sampled as a metal-rich pristine environment. A total of 35 strains from 8 different species were isolated in the presence of arsenate, arsenite, and antimonite. ACR3 and arsB genes were amplified from the sediment''s total DNA, and 4 isolates also carried ACR3 genes. Phenotypic multiple resistances were found in all strains, and 7 strains had recoverable plasmids. Purified plasmids were sequenced by Illumina and assembled by EDENA V3, and contig annotation was performed using the “Rapid Annotation using the Subsystems Technology” server. Determinants of resistance to copper, zinc, cadmium, cobalt, and chromium as well as to the antibiotics β-lactams and fluoroquinolones were found in the 3 sequenced plasmids. Genes coding for heavy metal resistance and antibiotic resistance in the same mobile element were found, suggesting the possibility of horizontal gene transfer and distribution of theses resistances in the bacterial population.  相似文献   

18.
The antibiotic‐resistance characteristics of bacterial strains in antibiotic production wastewater treatment plants (WWTP) that contain high concentrations of antibiotics are unknown, as are the environmental effects of the discharge of wastewater from such facilities. In this study, 417 strains were individually isolated from the effluent of a WWTP that treated penicillin G production wastewater, as well as from downstream and upstream areas of the receiving river. The minimum inhibition concentrations (MICs) of 18 antibiotics representing seven classes were then determined for each of these strains. Relatively high similarity in the bacterial composition existed between the wastewater and downstream river samples when compared with the upstream sample. High resistance ratios and MIC values were observed for almost all antibiotics in wastewater isolates, followed by strains from downstream river, of which the resistance ratios and levels were still significantly higher than those of upstream strains. The resistance ratios and levels also significantly differed among strains belonged to different species in the penicillin production wastewater effluent and downstream river. In both samples, the resistances to β‐lactam antibiotics were more frequent, with much higher levels, than the other class antibiotics. Then five clinically important resistant genes mainly coding for extended‐spectrum β‐lactamases (ESBLs) were determined for all strains, only blaTEM‐1 which did not belong to ESBL was detected in 17.3% and 11.0% of strains isolated from wastewater and downstream river respectively. Class I integrons were detected in 14% of wastewater isolates and 9.1% of downstream isolates, and primarily contained gene cassettes conferring resistance to aminoglycoside antibiotics. The unexpectedly high levels of multiple antibiotic resistance in strains from wastewater and downstream river were speculated to be mainly due to multidrug efflux systems.  相似文献   

19.
目的分析芜湖市第一人民医院革兰阴性病原菌分布情况及对常见抗菌药物的耐药程度,为临床抗菌药物的选择及其合理使用提供参考。方法收集2015年1月至2017年12月我院临床科室送检的细菌培养标本,采用法国生物梅里埃公司生产VITEK2compact全自动微生物分析系统及其配套试剂盒进行细菌鉴定及药敏试验,数据采用WHONET 5.6软件进行统计分析。对年度耐药株数使用R语言3.4.0软件进行分析。结果 2015-2017年我院共检出病原菌3 728株,其中革兰阳性菌1 055株,占28.3%;革兰阴性菌2 673株,占71.7%。革兰阴性菌中主要致病菌为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞杆菌、鲍曼不动杆菌,对青霉素类和第一代头孢菌素类抗菌药物高水平耐药。2017年这4种细菌对头孢唑林的耐药率均已达100.0%。鲍曼不动杆菌对头孢曲松的耐药率逐年上升,对头孢替坦连续3年耐药率均为100.0%,对氨苄西林/舒巴坦、氟喹诺酮类以及头孢吡肟耐药率未逐年上升,对亚胺培南耐药率变化显著,差异均有统计学意义(P0.05)。铜绿假单胞杆菌对氨曲南耐药率逐年上升,对氨基糖苷类及头孢他啶耐药率逐年下降,差异均有统计学意义(P0.05)。大肠埃希菌和肺炎克雷伯菌对头孢吡肟耐药率逐年下降,差异有统计学意义(P0.05)。结论我院住院患者病原菌以革兰阴性菌为主,不同病原菌对药物的敏感性各异,临床医生应结合患者情况和药敏结果综合分析,合理选用抗菌药物。  相似文献   

20.
Measurement of the IC50 of cis(Z)-clopenthixol and trans(E)-clopenthixol on 188 bacterial strains from human clinical specimens shows that the antibacterial activity of clopenthixol is exerted by both isomerical components and trans(E)-clopenthixol is the most active antibiotic of the two drugs against the sensitive strains. It is known that the trans(E)-clopenthixol isomere is without neuroleptic effect. The possibility of creating new antibiotics by e.g. steric alteration of neuroleptical agents is stressed. These drugs have different antibiotic patterns from those of classical antibiotics. It seems particularly promising that Pseudomonas aeruginosa is sensitive to these drugs.  相似文献   

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