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目的 了解煤工尘肺患者下呼吸道产金属内酰胺酶的铜绿假单胞菌(PA)的感染状况及其耐药特性。方法 分离下呼吸道感染的煤工尘肺患者痰液标本中的PA,根据药敏试验,筛选可疑产金属内酰胺酶PA,最后依据2 巯基丙酸双纸片法鉴定产金属内酰胺酶PA。结果 40株PA中共筛选出10株可疑PA,最终确定产金属内酰胺酶PA 6株。这些菌株均有很强的耐药性,对亚胺培南、头孢菌素、含酶抑制剂类抗菌药物全部耐药;对阿米卡星、环丙沙星、左氧氟沙星、庆大霉素等药物部分耐药。产金属内酰胺酶PA的耐药性远强于不产金属内酰胺酶的PA。结论 产金属内酰胺酶PA的耐药性很强,应加强煤工尘肺患者产金属内酰胺酶PA的检测,以利于指导治疗和控制感染。
Objective To understand the infection status and drug resistance of Pseudomonas aeruginosa (PA) producing metallo-lactamase in the lower respiratory tract of patients with coal worker’s pneumoconiosis. Methods The PA in the sputum of coal worker ’s pneumoconiosis patients with lower respiratory tract infection was isolated. Susceptible metalloelactamase PA was screened according to drug susceptibility test. The metallo - lactamase PA was identified by 2 - mercaptopropionic acid double disc method. Results Ten suspicious PA strains were screened from 40 strains of PA, and finally the metallo-lactamase PA 6 strains were determined. These strains have strong resistance, resistance to imipenem, cephalosporins, antibiotics containing inhibitors of all drug-resistant; amikacin, ciprofloxacin, levofloxacin, gentamicin, etc. Drugs partially resistant. The drug resistance of the metallo-lactamase PA is much stronger than that of the metal-free lactamase-producing PA. Conclusion The drug-resistance of metallo-lactamase producing PA is very strong. Detection of metallo-lactamase PA in coal workers with pneumoconiosis should be strengthened to guide the treatment and control of infection.