摘要
目的了解我院产超广谱β-内酰胺酶（ESBLs）大肠杆菌、肺炎克雷伯杆菌对临床常用抗生素的耐药情况，为临床治疗和控制ESBLs菌感染提供依据。方法从2003．1-2005．3我院住院部各科室患者送检的标本中分离出肺炎克雷伯菌和太肠埃希氏菌共229份（同一患者同一菌株只入选一次），其中肺炎克雷伯菌59例，大肠杆菌170例，采用Microscan-walkaway96全自动微生物分析仪NC21板进行细菌鉴定及12种抗菌药物的药敏测定，抑酶剂增强纸片法进行ESBL检测。结果产ESBLs菌56株，非产ESBLs菌173株，总检出率为28．14％（56／229），其中产ESBLs肺炎克雷伯杆菌12株，检出率为20．34％（12／59），产ESBLs大肠杆菌44株，检出率为25．88％（44／170）。产ESBLs菌与非产ESBLs菌对亚胺培南100％敏感。除亚胺培南、哌拉西林／他巴唑坦、阿米卡星外，产ESBLs菌对其他9种抗菌药物的耐药率均高于非产ESBL菌，其中，对阿莫西林、氨曲南、头孢曲松、头孢他啶均100％耐药。产ESBLs菌对喹诺酮类抗生素环丙沙星的耐药率为69．6％，作为产ESBL菌感染用药应慎重考虑。结论产ESBLs菌对常用抗生素耐药率较高．碳烯青霉素类抗生素亚胺培南是治疗产ESBL细菌感染的首选药物。
Objective To investigate the antibiotic resistance of ESBLs-producing Escherichia coli and Klebsiella pneumoniae to 12 kinds of antibacterial drugs in our hospital, provide bases for clinical control and treatment of ESBLs bacteria infection. Methods 229 non-duplicated strains of Escherichia coli and Klebsiella pneumoniae were collected from different wards in hospital during Jan .2003 to Mar.2005. 59 strains of Klebsiella pneumoniae and 170 strains of Escherichia eoli were identified by NC21 cards of Microscan-walkaway system and producing-ESBLs strains were detected by double-disk synergy test, and the antibiotic susceptibility of all strains were detected by Microscan-walkaway system. Results 56 strains producing ESBLs were found in 229 strains（28.14%）, including 12 strains Klebsiella pneumoniae（20.34% ） and 44 strains of Escherichia coli （25.88%）. All strains had 100% susceptibility to Carbapenem imipenem; Exept for imipenem, piperacillin/ tazothe and amikacin, ESBLs-producing strains had higher resistance rate to other 9 kinds of antibiotics than non-producing ESBLs strains, and had 100% resistance rate to ampicillin,Aztreonam, Ceftriaxone and Ceftzidime, To Ciprofloxacin , resistance rate were 69.6%. Conclusion ESBLs-producing Escherichia coli and Klebsiella pneumoniae had high resistance rate to clinical frequent applied antibiotics, and Imipenenem could be the best choiceto control the infection due to ESBLs-producing organisms.
出处
《中国实验诊断学》
2006年第1期55-57,共3页
Chinese Journal of Laboratory Diagnosis
关键词
超广谱Β-内酰胺酶
耐药性
Extended-spectrumβ-lactamases（ESBLs）
Antibiotic resistance
