摘要
目的分析产超广谱β-内酰胺酶（ESBLs）的老年人下呼吸道感染的常见肠杆菌科细菌的耐药性及特点。方法对老年人下呼吸道感染的肠杆菌科细菌用梅里埃ATB152微生物分析仪进行鉴定,检测ESBLs表型和药物敏感试验。结果在检测的肠杆菌科细菌中,ESBLs总阳性率为41.3%,大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌的产酶率分别为41.9%、51.9%和35.1%,261株产ESBLs的肠杆菌科细菌对亚胺培南全部敏感,产ESBLs的大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌对头孢唑啉、头孢噻肟、头孢曲松、头孢哌酮、头孢他啶等头孢类抗菌药物的耐药率高达96%～100%,但是对头孢哌酮/舒巴坦的耐药率较低,为18.4%～61.2%;对阿米卡星的耐药率为51.2%～88.6%。261株产ESBLs的肠杆菌科细菌对亚胺培南全部敏感,产ESBLs的大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌对头孢唑啉、头孢噻肟、头孢曲松、头孢哌酮、头孢他啶等头孢类抗菌药物的耐药率高达96%～100%,但是对头孢哌酮/舒巴坦的耐药率为18.4%～61.2%;对阿米卡星的耐药率为51.2%～88.6%。结论老年人下呼吸道感染产ESBLs的菌株对除碳青酶烯类之外的抗菌药物耐药率明显高于非产酶株。其治疗应选用亚胺培南或β-内酰胺酶抑制剂的复合制剂。
Objective To explore common ESBLs producing Enterobacteriaceae bacteria drug-resistance and resistance characteristics in the infected lower respiratory tract of the elderly, as well as risk factors of the ESBLs bacteria infection in the patients. Methods From April 2007 to August 2008,the bacteria of Enterobacteriaceae separated from the elderly infected lower respiratory tract were identified by BIOMERIEUX ATB1525 microbial analyzer, ESBLs phenotype and drug sensitivity were detected. Results In the detected Enterobacteriaceae bacteria,ESBLs positive rate was 41.3 %, Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae of the enzyme production rates were 41.9% ,51.9% and 35.1%, respectively. Conclusion All the ESBLs strains were sensitive to carbapenems, The resistance rate to most antibiotics was much higher than that of the non-ESBLs strains. The risk factors for ESBLs bacteria infection are long-term use of third-generation cephalosporins and immunosuppressive agents, and the susceptible patients may suffer from ICU, catheterization, major surgery, chronic wasting disease. For the treatment of ESBLs bacteria infection,imipenem or β-1actamase inhibitor of the complex might be chosen.
出处
《中国临床保健杂志》
CAS
2009年第3期265-267,共3页
Chinese Journal of Clinical Healthcare
关键词
呼吸道感染
Β内酰胺酶类
抗药性
多种
细菌
老年人
Respiratory tract infections
beta-lactamases
Drug resistance, multiple, bacterial
Aged
