摘要
目的：研究四川大学华西医院自2003年9月～2004年3月间分离的18株肺炎克雷伯杆菌对头孢菌素的耐药性及其机制,以指导临床合理使用抗生素.方法：收集、分离及鉴定肺炎克雷伯杆菌,用琼脂二倍稀释法及纸片扩散法测定临床分离肺炎克雷伯杆菌对6种抗菌药物的MIC值;头孢硝噻吩纸片法定性筛选细菌的β-内酰胺酶;通过NCCLS2004年版推荐的纸片扩散法初筛ESBLs;酶提取物三维实验检测高产AmpC酶的肺炎克雷伯杆菌.结果：从四川大学华西医院分离的18株肺炎克雷伯杆菌对头孢吡肟的耐药率为11.1%,对三代头孢菌素的耐药率都达到了22.2%～44.4%;18株实验菌中有11株产β-内酰胺酶,其中有9株产ESBLs和1株产AmpC酶.结论：产生β-内酰胺酶是肺炎克雷伯杆菌对头孢菌素类抗生素耐药的机制之一.
Object： Study on the resistant rates and resistance mechanisms of Klebsiella pneumoniae to cephalosporins isolated from West China hospital. Methods： After Klebsiella pneumoniae was collected,isolated and identified, a bacterial susceptibility test was examined by agar dilution method and the standard disk diffusion method, Nitrocefin method was used to screen of β-1actamase, a disc diffusion confirmatory test was used to detect ESBLs-producing strains as described in NCCLS2004, and three-dimensional test was used to detect strains which continuously producing high AmpC β-1actamase. Results： The resistant rate of the 18 strains Klebsiella pneumoniae to cefepime were 11.1% and 22.2% respectively, but the resistant rates to third generation cephalosporins was all higher from 22.2% to 66.7% ; 11 strains produced β-1actamase including 9 strains producing ESBLs and 1 strain producing AmpC enzyme. Conclusions： Production of β-lactamase is one of the resistance mechanisms of Klebsiella pneumoniae to cephalosporins.
出处
《四川生理科学杂志》
2006年第1期20-23,共4页
Sichuan Journal of Physiological Sciences
