标题：东莞地区耐碳青霉烯类铜绿假单胞菌的产酶情况及耐药性分析

      作者：庞彩莲，刘敏娟，林景涛，陈凯妮，黄嘉莹，吴品，周正维，许艳茹    东莞市大朗医院检验科，广东 东莞 523770

      卷次： 2021年32卷21期

      【摘要】 目的 研究东莞地区耐碳青霉烯类铜绿假单胞菌(CRPA)的产碳青霉烯酶情况及耐药性，为临床治疗及合理用药提供科学依据。方法 收集东莞地区2018年1月至2021年6月共216株CRPA进行鉴定及药敏试验，eCIM实验筛查碳青霉烯酶，双纸片扩散法检测产酶表型。结果 216株CRPA中产碳青霉烯酶83株，占38.4%，不产酶有133株，占61.6%。亚胺培南和美罗培南耐药率分别为96.1%和72.6%，庆大霉素14.1%，妥布霉素12.6%，阿米卡星5.5%，哌拉西林/他唑巴坦28.1%，头孢吡肟19.2%，左旋氧氟沙星25.9%，头孢他啶33.3%，环丙沙星31.0%，哌拉西林34.4%，头孢哌酮/舒巴坦37.9%。结论 产碳青霉烯酶不是东莞地区铜绿假单胞菌对碳青霉烯类抗生素耐药的主要机制。CRPA中除碳青霉烯酶耐药率较高外，其他绝大部分药敏耐药率均在40%以下，在用药时首选耐药率在30%以下的药物。
      【关键词】 东莞地区；耐碳青霉烯类铜绿假单胞菌；耐药性；丝氨酸酶；金属酶
      【中图分类号】 R378.99 【文献标识码】 A 【文章编号】 1003—6350（2021）21—2797—03
Enzyme production of carbapenem-resistant Pseudomonas aeruginosa in Dongguan and drug resistance analysis.PANG Cai-lian, LIU Min-juan, LIN Jing-tao, CHEN Kai-ni, HUANG Jia-ying, WU Pin, ZHOU Zheng-wei, XU Yan-ru.Department of Clinical Laboratory, Dongguan Dalang Hospital, Dongguan 523770, Guangdong, CHINA
【Abstract】 Objective To study the carbapenemase production and drug resistance of carbapenem-resistantPseudomonas aeruginosa (CRPA) in Dongguan, so as to provide scientific basis for clinical treatment and rational druguse. Methods A total of 216 strains of CRPA from January 2018 to June 2021 in Dongguan were collected for identifi-cation and drug sensitivity test. The carbapenem enzyme was screened by ECIM test, and the enzyme producing pheno-type was detected by double disk diffusion method. Results Among 216 CRPA strains, 83 strains produced carbapene-mase (accounting for 38.4%), and 133 strains did not produce carbapenemase (accounting for 61.6%). The drug resis-tance rates were 96.1% and 72.6% to mipenem and meropenem, 14.1% to gentamicin, 12.6% to tobramycin, 5.5% toamikacin, 28.1% to piperacillin/tazobactam, 19.2% to cefepime, 25.9% to levofloxacin, 33.3% to ceftazidime, 31.0% tociprofloxacin, 34.4% to piperacillin, 37.9% to cefoperazone/sulbactam. Conclusion Carbapenem producing enzyme isnot the main mechanism of carbapenem resistance of Pseudomonas aeruginosa in Dongguan. In CRPA, except for thehigh resistance rate of carbapenem enzyme, the drug sensitivity and resistance rate of most other drugs are less than40%, and the drugs with resistance rate less than 30% are preferred.
      【Key words】 Dongguan area; Carbapenem-resistant Pseudomonas aeruginosa; Drug resistance; Serinase; Metallo-enzyme·短篇论著·doi:10.3969/j.issn.1003-6350.2021.21.021基金项目：2020年广东省东莞市社会科技发展一般项目立项(自筹)(编号：202050715040581)