摘要
目的:了解我院产ESBLs肺炎克雷伯菌和大肠埃希菌在不同临床标本中的分布及耐药性。方法:采用CLSI推荐的双纸片协同试验。用头孢他啶、头孢他啶/克拉维酸和头孢噻肟、头孢噻肟/克拉维酸确证试验确认,检测我院2006年6月至2008年6月临床标本中分离出的85株产ESBLs肺炎克雷伯菌和156株产ESBLs大肠埃希菌。用K-B法进行药物敏感试验,并用上海新和实验室管理软件分析细菌分布和耐药性。结果:我院产ESBLs肺炎克雷伯菌在痰、咽试子、胸腹水、分泌物、胆汁、脓液、尿液中的检出率分别为42.2%、29.6%、17.9%、28.6%、30.8%、25.6%,产ESBLs大肠埃希菌在上述标本中检出率分别为33.3%、28.2%、43.6%、31.6%、25.0%、24.3%。各类标本中检出的产ESBLs肺炎克雷伯菌和大肠埃希菌均对亚胺培南敏感,对广谱青霉素类和头孢类抗生素耐药率高。结论:产ESBLs肺炎克雷伯菌和大肠埃希菌可分布于临床各种标本中,它们是β-内酰胺类抗生素耐药的重要机制。因此及时准确地检出ESBLs菌株对临床合理使用抗生素、防止细菌耐药性产生及控制耐药菌的播散和流行均有重要意义。
Objective：To study the distribution and drug resistance of Klebsiella pneumoniae and Escherichia coli with ESBLs in our hospital various clinical samples. Methods： Using double disk synergy test recommended by CLSI, which contained Ceftazidime, Ceftazidime/Clavulanic acid and Cefotaxime, Cefotaxime/Clavulanic acid, to detected 85 strains of Klebsiella pneumoniae and 156 strains of Escherichia coil with ESBLs isolated from clinical samples of our hospital during June 2006 - June 2008. The K - B assay was used for drug sensitivity test and the Lab management software producted by Shanghai Xinhe was used to analysis the distribution and drug resistance of the tow bacteria. Results：The detection rates of Klebsiella pneumoniae with ESBLs were 42. 2%, 29.6%, 17.9%, 28.6%, 30. 8% and 25.6% in sputum, throat swab, pleural and abdominal dropsy, secretion, bile, liquor purls and urine respectively, and the rates of Escherichia coli with ESBLs were 33.3% ,28.2% ,43.6% ,31.6%, 25.0% ,24. 3% in above samples. Both of tow bacteria were sensitive to Imipenem and had high drug resistance to broad - spectrum penicillins and Cephalosporins. Conclusion：Klebsiella pneumoniae and Escherichia coli with ESBLs exist in mamy clinical samples, and are major reasons for β- lactam antibiotics resistance. Therefore, quick and exact identification of the two bacteria is important for rational use of antibiotics, prevention of drug resistance and control of prevalence of drug - resistance bacteria.
出处
《中国卫生检验杂志》
CAS
2009年第4期872-873,918,共3页
Chinese Journal of Health Laboratory Technology
