马来西亚某三级医疗中心铜绿假单胞菌耐药性分析

Mohd Ali Faiz, C. H. Ding, A. Wahab, M. N. Tzar, A. Sulong, K. Wong, P. F. Wong
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摘要

背景:铜绿假单胞菌是一种臭名昭著的革兰氏阴性细菌,由于出现了多重和普遍耐药菌株,已成为全球公共卫生关注的问题。本研究旨在确定马来西亚三级医疗中心铜绿假单胞菌的抗生素敏感性。材料与方法:使用VITEK 2 GN试剂盒确认每个分离株的鉴定,并使用VITEK 2 AST-N374卡(用于检测哌拉西林他唑巴坦、头孢他啶、头孢吡肟、亚胺培南、美罗培南、阿米卡星、庆大霉素和环丙沙星)和耐药试纸(用于检测多利培南和多粘菌素B)进行抗生素敏感性试验。使用改进的碳青霉烯类失活法(mCIM)检测对bbb1碳青霉烯类不敏感的分离株的碳青霉烯酶产率。结果:102株分离菌中64株(62.7%)对所有抗生素均完全敏感。对>2类>1耐药26例(25.5%),对>3类>1耐药21例(20.6%)。多粘菌素B的敏感性最高(100%),哌拉西林-他唑巴坦最低(64.7%)。碳青霉烯敏感性在78.4% ~ 81.4%之间。22株对bbb1碳青霉烯类不敏感的菌株中,18株(81.8%)对3种碳青霉烯类均不敏感。结论:半数以上铜绿假单胞菌对所有抗假单胞菌抗生素均完全敏感。耐多药菌株占我们所有铜绿假单胞菌分离株的20%至25%。通过mCIM测试,碳青霉烯酶的产生似乎不是主要的耐药机制。[J]中华医学杂志2022;23: 54-60
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The Antibiotic Resistance Profile of Pseudomonas Aeruginosa in a Tertiary Medical Center from Malaysia
Background: Pseudomonas aeruginosa is a notorious gram-negative bacterium that has become a globalpublic health concern owing to the emergence of multi- and pandrug-resistant strains. This study sought todetermine the antibiotic susceptibility profile of P. aeruginosa in a tertiary medical center from Malaysia. Materials and Methods: Each isolate’s identity was confirmed using the VITEK 2 GN kit, and subjectedto antibiotic susceptibility testing using the VITEK 2 AST-N374 card (for testing against piperacillintazobactam,ceftazidime, cefepime, imipenem, meropenem, amikacin, gentamicin and ciprofloxacin) andEtest strips (for testing against doripenem and polymyxin B). Isolates which were not susceptible to >1carbapenem were tested for carbapenemase production using the modified carbapenem inactivationMethod (mCIM). Results: Out of 102 isolates studied, 64 (62.7%) were fully susceptible to all the antibiotics tested.Twenty-six (25.5%) were resistant to >1 antibiotic from >2 antibiotic classes, and 21 (20.6%) wereresistant to >1 antibiotic from >3 classes. Susceptibility was highest with polymyxin B (100%) and lowestwith piperacillin-tazobactam (64.7%). Carbapenem susceptibility was between 78.4% to 81.4%. Out of 22isolates which were not susceptible to >1 carbapenem, 18 (81.8%) were not susceptible to all threecarbapenems. Conclusion: More than half of our P. aeruginosa isolates were fully susceptible to all the anti-pseudomonalantibiotics tested. Multidrug-resistant strains accounted for between 20% to 25% of all our P. aeruginosaisolates. Through mCIM testing, carbapenemase production did not appear to be the dominant resistancemechanism. J MEDICINE 2022; 23: 54-60
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