摘要
目的 了解肺部感染患者肠杆菌科产ESBLs细菌的临床特点、耐药性及对策。方法2001年2月～2004年9月，从本院住院肺部感染患者痰标本中做细菌培养，采用K—B琼脂扩散法和ESBLs确证试验进行ESBLS的检测。结果 共培养出肠杆菌科细菌541株，其中产ESBLs菌135株；药敏试验耐药率对亚胺培南最低为0，其次为头孢哌酮／舒巴坦、哌拉西林／他唑巴坦，分别为31．11％和44．44％；产ESBLs菌株较不产ESBLs菌株表现为对抗菌药物明显高的耐药率（P＜0.01）；共筛选出入住ICU、侵袭性医疗操作、三代头孢菌素应用等6个危险因素。结论 肺部感染患者中肠杆菌科细菌产ESBLs较严重，产ESBLs菌对大多数抗菌药物耐药性比非产ESBLs菌严重，严胺培南是治疗由产ESBLs菌引起感染最有效抗菌药物。
OBJECTIVE To survey the patient with pulmonary infection induced by extended-spectrum β-lactamasesproducing bacteria and their Enterobacteriaceae clinical characteristics, drug-resistance and countermeasure. METHODS Isolation, cultivation, identification, drug-sensitivity tests and confirmation of ESBLs-producing bacteria were done for the bacteria of sputum specimens collected from our hospital from Feb 2001 to Sept 2004. Susceptibility testing was performed by disk diffusion （K-B）method. RESULTS Totally 541 strains of Enterobacteriaceae were cultivated altogether and ESBLs-producing bacteria were 135 strains. The ESBLs-producing strains were sensitive to imipenem, and the resistance rates to it were 0.00%. The resistance rates of ESBLs-producing strains to cefoperazone/sulbactam and piperacillin/tazobactam were 31. 11% and 44. 44%, respectively. The multi-drug-resistance （MDR） rate of ESBLs-producing strains was higher than that of strains no producing ESBLs（P〈0.01）. Totally 6 risk factors such as ICU ward, invasive medical manipulations, use of the third generation cephalosporins, etc were determined. CONCLUSIONS The prevalence of ESBLs from Enterobacteriaceae is high in clinical isolates from pulmonary infection patients. The resistant rates of ESBLs-producing strains to most antibiotics are higher than non-ESBLs-producing ones. Imipenem is the most effective antibiotic to infections caused by ESBLs-producing strains and several risk factors are existed in ESBLs-producing strains. We should pay more attemtion to ESBLs in clinics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2006年第9期1061-1064,共4页
Chinese Journal of Nosocomiology
关键词
产超广谱Β-内酰胺酶
肺部感染
危险因素
耐药
Extended-spectrum β-lactamases
Pulmonary infection
Risk factors
Drug-resistance
