摘要
目的研究煤工尘肺产超广谱β-内酰胺酶(ESBLs)细菌感染及其耐药情况。方法对从煤工尘肺肺部感染患者痰标本分离的264株革兰阴性杆菌进行ESBLs检测,并检测产ESBLs细菌的药物敏感性。结果共检出产ESBLs细菌62株,占全部测试菌株的23.48%,其中主要包括肺炎克雷伯菌29株、大肠埃希菌27株。产ESBLs细菌对氨苄西林均高度耐药;对头孢噻肟、头孢他定等第三代头孢菌素类也高度耐药;而头孢西丁对产ESBLs肺炎克雷伯菌及大肠埃希菌有较强的抗菌效果,但产ESBLs铜绿假单孢菌和阴沟肠杆菌对头孢西丁的耐药率却高达100%;除铜绿假单胞菌外的产ESBLs细菌对亚胺培南的敏感率极高;奈替米星、阿米卡星及氧氟沙星、环丙沙星对产ESBLs细菌抗菌作用较弱。结论煤工尘肺患者产ESBLs细菌尤其是产ESBLs肺炎克雷伯菌和大肠埃希菌引起的肺部感染情况较严重,亚胺培南可作为治疗产ESBLs细菌(铜绿假单胞菌除外)的首选药,临床应采取措施以预防产ESBLs细菌肺部感染的发生。
Objective To study extended-spectrum β-lactamase （ESBLs） producing bacilli causing pulmonary infection and drug resistance in coal worker＇s pneumoconiosis （CWP） patients. Methods 264 Gram-negative bacilli isolated from sputum samples of coal pneumoconiosis patients suffering from pulmonary infection were detected for the presence of ESBLs, and drug resistance assay was subsequently conducted to ESBLs-producing strains. Results 62 strains （23.48%） were found ESBLs positive, including mainly 29 K. pneumoniae and 27 E. coli. All ESBLs-producing bacilli showed high resistance to cefetaxime and ceftazidime as well as ampicillin. Cefoxitin showed powerful antibacterial activity to ESBLs-producing K. pneumoniae and E. coli, while ESBLs-producing P. aeruginosa and E. cloacae showed 100% resistance to cefoxitin. Imipenem was high effective to all ESBLs-producing bacilli except for P. aeruginosa. Netilmicin, amikacin, ofloxacin and ciprofloxacin had feeble antibacterial effects on ESBLs-producing bacilli. Conclusions It seems that pulmonary infection caused by ESBLs-producing bacilli, especially by ESBLs-producing K. pneumoniae and E. coli, is quite serious in coal pneumoconiosis patients. Imipenem may be considered as the preferred drug to cope with ESBLs-producing bacilli except for P. aeruginosa, and necessary measures should be applied to prevent the occurrence of pulmonary infection caused by ESBLs-producing bacilli.
出处
《中国职业医学》
CAS
北大核心
2005年第5期17-19,共3页
China Occupational Medicine
关键词
煤工尘肺
肺部感染
超广谱Β-内酰胺酶
耐药性
Coal worker＇s pneumoconiosis （CWP）
Pulmonary infection
Extended-spectrum β-1actamase （ ESBLs ）
Drug resistance
