Analyze Resistant Of Bacteria And Homology Of Pseudomonas Aeruginosa In Yunnan Burn Center

Objective:Analyze resistance of bacteria and the homology of Pseudomonas aeruginosa of Burn Center separation of Kunming Medical University, to guide clinical practice.Methods:①For2010-2012isolated from Yunnan burn center burn infection in patients with various types of specimens Gram-negative bacteria, the use of French bioMerieux VITEK2COMPACT automatic bacterial identification system to identify bacteria, with disk diffusion method (KB France) for drug susceptibility testing, analysis burn Center on a variety of Gram-negative bacteria commonly used antimicrobial drug resistance.②randomly collected in March2012August2012burn center separation of non-repetition of Pseudomonas aeruginosa58, double disk synergy test metalloenzymes phenotypic confirmatory test; using polymerase chain reaction (PCR) detection of metal gene (imp, vim, spm, gim); pulsed-field gel electrophoresis (PFGE) analysis of carbapenem-resistant strains homology.Results:①From the burn patients were isolated from2105strains of pathogenic bacteria, gram positive bacteria accounted for27.9%(588/2105), the most common gram positive bacteria were Staphylococcus aureus (321/2105), coagulase negative staphylococcus (177/2105), Enterococcus faecalis(58/2105), Enterococcus faecium (20/2105); gram negative bacteria accounted for72.1%(1517/2105), gram negative bacteria6strains were Pseudomonas aeruginosa (733/2105), Acinetobacter (397/2105), Klebsiella(120/2105), Enterobacter spp.(77/2105), proteus (50/2105) and Escherichia coli (48/2105). Drug sensitivity test showed:gram positive bacteria, methicillin resistant Staphylococcus aureus (MRSA) the detection rate of46.9%, methicillin-resistant Staphylococcus aureus resistant to ciprofloxacin, levofloxacin, cotrimoxazole rate was higher than93%, Staphylococcus aureus and Enterococcus resistance without vancomycin, linezolid found. Gram negative bacillus, Pseudomonas aeruginosa resistant to imipenem and meropenem were92.3%and90.2%, for Amikacin, minocycline, aztreonam, ceftazidime, cefepime, cefoperazone-Shubatan and piperacillin tazobactam resistant rate was55.5%～91.3%, exhibited multiple drug resistance situation, Acinetobacter resistance to imipenem and meropenem were82.2%and81.6%, to ceftazidime, cefepime, aminoglycosides and fluoroquinolones and other antimicrobial drug resistance rate is higher. Enterobacteriaceae bacteria to ampicillin, piperacillin, ceftazidime, cefotaxime resistance, cotrimoxazole rate is greater than50%.Detection of a handful of Pseudomonas aeruginosa, Acinetobacter and Bauman of Klebsiella pneumoniae resistant to antimicrobial use (except for polymyxin outer) Pan drug resistant strains were resistant. Double disk synergy test showed,58strains of Pseudomonas aeruginosa in8strains of metal enzyme phenotype positive; PCR results showed that58strains,8strains of Pseudomonas aeruginosa by detection of metal enzyme genes were VIM positive strains, no detection of IMP, SPM and GIM type metal enzyme, and metal enzyme phenotype the positive agreement; screened52strains of carbapenem resistant strains in58strains of Pseudomonas aeruginosa,6strains of Pseudomonas aeruginosa to carbapenem antibiotic sensitive strains. On52strains of carbapenem resistant strains were PFGE homology analysis, the result is divided into3type. The type A are20strains, type B are17strains, type C are15strainsConclusions:The main pathogenic bacteria of burn in the top three were Pseudomonas aeruginosa, Acinetobacter spp, Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter resistance to carbapenem antibiotic yield>80%, resistance to other antibiotics was>70%, Cray primary sp., enterobacter, degeneration bacterium, Escherichia coli resistant to beta lactam was>70%, the sensitivity rate to carbapenem antibiotics were>93%, to the quinolones antibiotics resistance rate of>43%, methicillin-resistant Staphylococcus aureus resistant to ciprofloxacin, left ofloxacin, cotrimoxazole is93%higher than the rate of bacteria. Staphylococcus aureus and Enterococcus no vancomycin resistant, linezolid was found, these results suggest that resistance of the severe bum center, should strengthen the burn center the rate of bacterial drug resistance monitoring, to guide the clinical rational drug use and multiple drug-resistant strains reduced.58strains of Pseudomonas aeruginosa in8strains of metal enzyme phenotype positive, PCR amplification of metal enzyme genotype VIM, imp, SPM and GIM were not detected in the other metal enzyme gene. The results show that the main mechanism of burn center in Yunnan province of Pseudomonas aeruginosa carbapenem antibiotic resistance may not be metallo beta lactamase resistant mechanism, there other such as loss of outer membrane proteins, efflux pump expression, remains to be studied further.52strains (8strains containing metal enzyme gene positive strains) carbapenem antibiotic resistant strains of PFGE homology analysis revealed3types, showed that the drug resistance of Pseudomonas aeruginosa in the presence of various clones real popular in hospital burn disease, has the risk of infection outbreak, should strengthen the medical staff hand hygiene, blocking transmission, prevent multiple epidemic of Pseudomonas aeruginosa in burn ward outbreak.