摘要
目的了解产超广谱β-内酰胺酶(ESBLs)革兰阴性杆菌在医院内的分布及对抗菌药物的耐药性,以利于对ESBLs细菌的监控和治疗。方法用VITEK TWO型全自动细菌分析系统对细菌进行鉴定和药敏检测,对疑似ESBLs菌株用纸片扩散法确认。结果共分离出肠杆菌科细菌1 889株,其中ESBLs细菌共302株;在551株大肠埃希菌、583株肺炎克雷伯菌和755株其他肠杆菌科细菌中,ESBLs菌的检出率分别为102株(18.5%)、144株(24.7%)、56株(7.4%);各病区产ESBLs菌的分离率以外科重症监护病房(SICU)最高(38.2%),其次为内科重症病房(29.9%)、外科病房(20.5%)、肿瘤科病房(20.6%)、呼吸科病房(12.7%)、血液科病房(12.4%)、干部病房(10.3%)、内分泌病房(6.4%)、其他病房(1.6%);产ESBLs菌对亚胺培南、美罗培南敏感度较高。结论VITEK TWO型全自动细菌分析系统可对肠杆菌科细菌进行快速检测,医院内ICU病房和长期住院的慢性重症患者是产ESBLs菌的主要来源,对产ESBLs菌的治疗以亚胶培南、美罗培南最佳,其次为哌啦西林/他唑巴坦和头孢哌酮/舒巴坦。
OBJECTIVE To investigate the distribution and drug-resistance of extended-spectrum β-lactamases （ESBLs） producing Gram-negative bacteria in the hospital, in order to control and treat them. METHODS The bacteria were detected and isolated with VITEK TWO system, the suspected ESBLs producing bacteria were detected with K-B method. RESULTS There were 1 889 isolated strains of Enterobacteriaceae and the ESBLs producing bacteria were 302 strains including E. coli （551）, K. pneumoniae （583）, and others bacteria （755）. Their positive rates bacteria were 18.5%, 24.7%, and 7. 4%, respectively; the wards isolated rate was in the fol- lowing order： 38.2% were in surgical ICU, 29.9% in medical ICU, 20. 5% in surgery wards, 20. 6% in oncology wards, 12.7% in respiratory wards. 12.4% in hematology wards, 10. 3% in cadre wards, 6.4% in endocrinology wards, and 1.6% were in others wards. ESBLs producing bacteria were better sensitive to imipenem and mero- penem, then to piperacillin/tazobactam and cefoperazone/sulbactam. CONCLUSIONS Enterobacteriaceae could be detected accurately with VITEK TWO system. The main sources of ESBLs producing bacteria are patients in ICU and chronic patients. To kill these bacteria, imipenem and meropenem can be used first, then piperacillin/tazobactam and cefoperazone/sulbactain.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2006年第7期814-816,共3页
Chinese Journal of Nosocomiology
关键词
产超广谱Β-内酰胺酶
医院内分布
耐药性
Extended-spectrum β-lactamases（ESBLs） ； Distribution in hospital
Resistance
