摘要
目的:分析我院产超广谱β内酰胺酶(ESBL)菌的流行情况及其对常用抗生素的耐药性,为临床合理选择抗生素提供依据。方法:对我院2003年1月至2004年6月临床标本中分离的肺炎克雷伯氏菌和大肠埃希氏菌,采用Vitek32全自动细菌鉴定和药敏分析仪进行ESBL检测和药敏实验。结果:34.3%(65/189)的肺炎克雷伯氏菌和35.6%(158/444)大肠埃希氏菌产ESBL,产ESBL菌对青霉素类、头孢菌素类和单环类抗生素耐药率在90%以上,对三代头孢菌素、单环类(氨曲南)、氨基糖苷类(庆大霉素)、喹诺酮类(环丙沙星、左旋氧氟沙星)的耐药率明显高于不产ESBL菌(P<0.05);对加酶抑制剂的复合药如阿莫西林/棒酸、哌拉西林/他唑巴坦的耐药率也显著高于不产ESBL菌(P<0.05)。产ESBL和不产ESBL肺炎克雷伯氏菌和大肠埃希氏菌对亚胺培能均未发现耐药。结论:ESBL细菌的监测对临床用药具有重要意义。
Objective:To investigate the epidemiology of ESBL producing strains in the hospital and to provide suggestions empirical treatment against the bacteria. Methods:Six hundred and thirty three strains of E. coli and K pneumonia from January 2003 to July 2004 were examined for the production of ESBL and antibacterial susceptibility test by Vitek-32. Results:There were 34.3% (65/189) of K pneumonia and 35.6% (158/444) of E. coli that produced ESBL; The resistance rate of the ESBL-producing strains to cefotaxime , ceftriaxone, ceftazidime, aztreonam were over 90% and the resistance rates of the ESBL-producing strains to the third enerationcefhalosorins,aminoglycosides,quinolones,amoxicillin/clavulanate,pipepracillin/tazobactam were significantly higher than those of the Non-ESBL-producing strains(P<0.05); Both ESBL-producing and Non-ESBL-producing strains were susceptible to imipenem. Conclution:ESBL-producing strains are very common and monitoring the ESBL-producing bacteria should be important for clinical treatment.
出处
《实用临床医学（江西）》
CAS
2005年第6期3-4,8,共3页
Practical Clinical Medicine
关键词
超广谱Β-内酰胺酶
肺炎克霄伯氏菌
大肠埃希氏菌
药敏试验
extended-spectrum β-lactamase(ESBL)
E scherichia(E.coli)
K lebsiella pneumonia(KL.pneumonia)
antimicrobial susceptibility test
