摘要
目的 监测并分析该医院2004年1～12月间产超广谱β-内酰胺酶（ESBLs）大肠埃希菌、肺炎克雷伯菌的耐药性变化，为临床合理使用抗菌药物提供指导。方法 对2004年1～12月从该院临床送检的各类标本中分离的大肠埃希菌和肺炎克雷伯菌，采用纸片琼脂扩散法（K-B法）与Vitek-AMS的GNS卡Mic法相结合进行药敏试验，并严格按照CLSI／NCCLS（美国临床实验室标准化研究所／美国临床实验室标准化委员会）推荐的标准方法检测ESBLs菌株。结果 分离的498株大肠埃希菌中，产ESBLs的有196株，占39．4％；311株肺炎克雷伯菌中，产ESBLs的有91株，占29．3％。产ESBLs菌株对青霉素类、头孢菌素类、单环β-内酰胺类、氨基糖甙类、氟喹诺酮类等抗菌药物产生多重耐药性；ESBLs菌株的耐药性显著高于非ESBLs菌株（P〈0．05），但对亚胺培南都显示高度敏感性。结论 产ESBLs菌株的感染已成为临床抗感染治疗的难题，临床在抗感染治疗过程中，应严格掌握抗菌药物的应用指标，特别加强对产ESBLs菌株的耐药性监测，合理使用各种抗菌药物，以防止ESBLs菌株的增长、扩散与流行。
Objective To monitor the trend of antibiotic resistance rate of extended-spectrum β- lactamases （ESBLs） producing K. pneumoniae and E. coli in our hospital from Jan 2004 to Dec 2004, in order to provide a guidance to clinical rational use of antibiotics. Methods In the period of the study in 2004, E. coli and K. pneumoniae strains were collected, which were isolated from patients in our hospital. Disc diffusion test （K-B method） and Mic method were combined to study the antibiotic resistance. ESBLs-producing strains were detected according to CLSI/NCCLS recommended ways. Results A total of 196 strains of E. coli were considered ESBLs, and the positive rate was 39.4%. Isolated from K. pneumoniae, 91 strains were considered ESBLs, and the positive rate was 29.3 %. The ESBLs-producing strains displayed multi-resistance to penicillin, cephalosporin, monobactam, aminoglycoside and quinolone. The resistance rate of ESBLs producing strains was significantly higher than that of ESBLs non-producing strains （P〈0.05）, but both of them were still highly sensitive to imipenem. Conclusion The high constituent ratio of ESBLs-producing bacteria and high MDR rates make them very difficult for clinical treatment of infection, which suggests that it be urgent to reduce the amount of ESBLs-producing bacteria. In order to prevent ESBLs-producing K. pneumoniae and E. coli infection outbreak, sputum culture and drug sensitivity should be emphasized before medication and wide-spectrum antibiotics should be applied rationally.
出处
《国际检验医学杂志》
CAS
2007年第4期304-306,376,共4页
International Journal of Laboratory Medicine
关键词
Β内酰胺酶类
大肠杆菌
克雷伯菌
肺炎
抗药性
细菌
Beta-lactamases
Esherichia coli
Klebsiella pneumoniae
Drug resisitance, bacterial
