摘要
目的了解昆明市第一人民医院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的检出及耐药情况。方法对该院2006年1—12月临床分离的293株大肠埃希菌,用表型确证试验检测ESBLs,K-B琼脂纸片扩散法做药物敏感试验。结果 293株大肠埃希菌中,检出产ESBLs菌168株(57.34%)。各类标本中,产ESBLs率以痰标本分离株(64.71%)最高,其次为血液(62.50%)和脓液标本(57.14%);各科室中,产ESBLs率以重症监护室(ICU)分离株(65.22%)最高,其次为内分泌科(65.00%)和肿瘤科(63.33%)。除亚胺培南和阿米卡星外,产ESBLs菌对其他14种常用抗菌药物的耐药率均明显高于非产ESBLs菌(均P<0.01);产ESBLs菌株不仅对青霉素、头孢菌素、氨曲南等抗生素广泛耐药,同时对喹诺酮类、氨基糖苷类、磺胺类等多种抗菌药物耐药,仅对亚胺培南、阿米卡星的耐药率<5%(分别为0.00%、3.30%)。结论昆明市第一人民医院临床分离大肠埃希菌产ESBLs率较高;产ESBLs菌株对临床常用多种抗菌药物严重耐药,可经验选用的药物十分有限。临床医生应根据病原菌药敏结果合理选用抗菌药物,以提高治疗效果。
Objective To investigate the antimicrobial resistance of extended-spectrum β-lactamases（ESBLs） of Escherichia coli （E. coli） isolated from the First People＇s Hospital of Kunming. Methods 293 strains of E. coli were isolated between January and December, 2006, ESBLs of E. coli were confirmed by phenotype confirmatory test, antimicrobial susceptibility were detected by Kirby-Bauer method. Results 168 of 293 （57. 34%） strains of E. coli were ESBLs-producing strains. The main specimens isolated ESBLs-producing strains was sputum （64. 71%）, the next were blood （62. 50%） and pus （57. 14%） ; Among departments, intensive care unit had the highest isolation rate of ESBLs-producing E. coli（65.22 %）, the next were department of endocrinology（65.00%） and oncology（63.33 %/00）. Except imipenem and amikacin, the resistant rates of ESBLs-producing strains against the other 14 antimicrobial agents were significantly higher than non-ESBLs-producing strains （all P〈0. 01 ）; ESBLs- producing strains were resistant to penicillins,cephalosporins, aztreonam, quinolones, aminoglycosides and sulfonamides, the resistant rate to imipenem and amikacin was both -%5%, which was 0. 00% and 3.30% respectively. Conclusion The prevalence of ESBLs is high among clinical E. coli isolates in the First People＇s Hospital of Kunming; ESBLs-producing strains are highly resistant to multiple antimicrobial agents, clinicians should choose antimicrobial agents rationally.
出处
《中国感染控制杂志》
CAS
2009年第6期423-425,437,共4页
Chinese Journal of Infection Control
关键词
大肠埃希菌
超广谱Β-内酰胺酶
抗药性
微生物
抗菌药物
合理用药
Escherichia coli
extended-spectrum β-lactamases
drug resistance, microbial
antimicrobial agents
rational use of drug
