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铜绿假单胞菌在伤口感染中的临床微生物学研究及金属β-内酰胺酶产生情况的检测

Clinico-microbiological study of Pseudomonas aeruginosa in wound infections and the detection of metallo-β-lactamase production.

作者信息

Bangera Divya, Shenoy Suchitra M, Saldanha Dominic Rm

机构信息

Department of Microbiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.

Department of Microbiology, Kannur Medical College, Anjarakandy, Kerala, India.

出版信息

Int Wound J. 2016 Dec;13(6):1299-1302. doi: 10.1111/iwj.12519. Epub 2015 Oct 30.

Abstract

Pseudomonas aeruginosa is a common opportunistic pathogen of humans among the Gram-negative bacilli. Clinically, it is associated with nosocomial infections like burns and surgical-site wound infections and remains a major health concern, especially among critically ill and immunocompromised patients. This is a prospective laboratory-based 2 year study conducted to isolate P. aeruginosa from wound specimens and the antimicrobial susceptibility pattern with reference to metallo-β-lactamase (MBL) production. Two hundred and twenty-four samples of P. aeruginosa isolated from wound specimens were included in the study. Antimicrobial susceptibility was done as per Clinical Laboratory Standard Institute (CLSI) guidelines. MBL-producing P. aeruginosa was detected using the EDTA disk diffusion synergy test. Statistical analysis was done using the SPSS 11 package (SPSS Inc., Chicago, IL). Out of the 224 P. aeruginosa isolates, 100% were susceptible to polymyxin B and colistin, 92·8% were sensitive to imipenem, 38% showed resistance to gentamicin followed by ceftazidime (31·69%) and meropenem (33·03). Sixteen (7·14%) isolates showed MBL production. Infection caused by drug-resistant P. aeruginosa is important to identify as it poses a therapeutic problem and is also a serious concern for infection control management. The acquired resistance genes can be horizontally transferred to other pathogens or commensals if aseptic procedures are not followed.

摘要

铜绿假单胞菌是革兰氏阴性杆菌中常见的人类机会致病菌。临床上,它与烧伤和手术部位伤口感染等医院感染相关,仍然是一个主要的健康问题,尤其是在重症和免疫功能低下的患者中。这是一项基于实验室的前瞻性两年研究,旨在从伤口标本中分离铜绿假单胞菌,并参考金属β-内酰胺酶(MBL)的产生情况研究其抗菌药敏模式。从伤口标本中分离出的224株铜绿假单胞菌样本纳入了该研究。根据临床实验室标准协会(CLSI)指南进行抗菌药敏试验。使用EDTA纸片扩散协同试验检测产MBL的铜绿假单胞菌。使用SPSS 11软件包(SPSS公司,伊利诺伊州芝加哥)进行统计分析。在224株铜绿假单胞菌分离株中,100%对多粘菌素B和黏菌素敏感,92.8%对亚胺培南敏感,38%对庆大霉素耐药,其次是头孢他啶(31.69%)和美罗培南(33.03%)。16株(7.14%)分离株产MBL。识别由耐药铜绿假单胞菌引起的感染很重要,因为它带来了治疗难题,也是感染控制管理的严重问题。如果不遵循无菌程序,获得性耐药基因可水平转移至其他病原体或共生菌。

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Metallo-beta-lactamases: the quiet before the storm?金属β-内酰胺酶:暴风雨前的宁静?
Clin Microbiol Rev. 2005 Apr;18(2):306-25. doi: 10.1128/CMR.18.2.306-325.2005.

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