摘要
目的调查郧西县医院大肠埃希菌超广谱β-内酰胺酶的流行情况,分析产超广谱β-内酰胺酶细菌的耐药性。方法选择该院细菌室非重复分离大肠埃希菌,标准纸片扩散法检测超广谱β-内酰胺酶,琼脂扩散法检测其对14种抗菌药物的耐药性。结果从各种临床标本中共分离出大肠埃希菌181株,产超广谱β-内酰胺酶菌株60株,其流行率为33.1%,153株产ESBLs大肠埃希菌对二代头孢菌素的耐药率大于90%;对其他β-内酰胺的耐药率在12.5%～55%之间;对氨基糖苷类的庆大霉素、氟喹诺酮类的环丙沙星、四环素的耐药率在70%～90%之间。上述药物中头孢他啶、阿米卡星的MIC50仍在敏感范围,氨曲南的MIC50已达中介范围,其他抗菌药物的MIC50和MIC90均处于耐药范围。只有碳青霉烯类的亚胺培南全部敏感。产ESBLs和ESBLs阴性大肠埃希菌的耐药率比较:除哌拉西林/他唑巴坦差异无显著性,其他抗菌药物差异有极显著性。结论该院大肠埃希菌ESBLs检出率为32.7%,产ESBLs菌株对多类药物表现出较高的耐药率,仅对碳青霉烯类的亚胺培南全部敏感。
Objective To investigate the isolated rate of extended spectrum beta- lactamases carried in Escherichia coli in People＇s Hospital of Yunxi County, and to analyze their drug resistance to 14 kinds of antibacterial agents. Methods A total of 181 strains of Escherichia coli were isolated from People＇s Hospital of Yunxi County. The minimum inhibitory concentration （MIC） of 14 antibacterial agents against the clinical isolates was detected by double agar dilution method. Results Sixty ESBLs - producing strains were detected in the 181 strains of Escherichia coli, and the detection rate was 33. 1 %. The drug resistance rates of 153 E. coli strains of ESBLs producers to second generation cephlosporins were exceeded 90% ; to other cephlosporins, the drug resistance rates were between 12.5 % and 55 %. For gentamicin, ciprofloxacin, and tetracycline,the drug resistance rates were between 70 % and 90 %. MIC50 for ceftizodime and amikacin was in susceptibility. For aztreonam, MIC50 has reached to intermediate. MIC50 and MICg0 for the other antibacterial agents were in resistance. However, all of these ESBLs producers were susceptible to imipenem. The difference for ESBLs- producing E. coli compared with non ESBLs- producing E. coli in amikacin and tetracycline were significant, while the resistance to piperacillin / tazobactam was insignificant; but to other antibacterial agents the resistance was highly significant. Cenclusiens The rate of ESBLs- producing in E. coli was 32. 7 %. Extended spectrum beta - lactamase producers show more prominent drug resistances to most of the antibacterial agents, while all of these detected strains remain susceptible to imipenem.
出处
《实用预防医学》
CAS
2007年第5期1559-1561,共3页
Practical Preventive Medicine
关键词
大肠埃希菌
超广谱Β-内酰胺酶
抗菌药物
耐药性
Escherichia coli
Extended spectrum beta- lactamases
Antibacterial agents~ Drug resistance
