摘要
目的：为探讨肠杆菌科细菌对β－内酰胺类药物的耐药性与其产生的超广谱β－内酰胺酶（ＥＳＢＬ）和诱导型β－内酰胺酶（ＩＢＬ）的关系。方法：采用琼脂稀释法、Ｅｔｅｓｔ法和相邻纸片法分别测定了１２种β－内酰胺类药物对肠杆菌科细菌的最低抑菌浓度（ＭＩＣ），超广谱β－内酰胺酶和诱导型β－内酰胺酶，并对产酶组与非产酶组的药敏结果进行比较。结果：１６３株肠杆菌科细菌中，ＥＳＢＬ阳性１１％（１８株），ＩＢＬ阳性１７．２％（２８株）。ＥＳＢＬ阳性菌株对１２种抗生素中的９种呈现多重耐药，其耐药率介于３３．３％～１００％； ＥＳＢＬ阴性菌株仅对氨苄西林、羧苄西林和头孢唑啉耐药，对其它药物均较敏感。ＩＢＬ阳性与阴性组之间其对耐药情况无明显差异，提示常规药敏试验未能完全反映细菌的耐药性。结论：由此认为，常规进行 ＥＳＢＬ， ＩＢＬ检测，可纠正常规药敏试验造成的假象，指导临床合理使用β－内酰胺类药物。
objective: To study the relationship between the resistant of enterobacteriaceae against 12 β-lactam antibotics and extended-spectrum β－lactamase (ESBL), induction β－lactamase (IBL). Methods: The minimal inhibitory concentration (MIC) of β－lactam antibiotics, ESBL and IBL were tested against 163 strains of enterobacteriaceae from infectious samples by the agar dilution method, Etest method and disk appreximation method, respectively. And assays the susceptible results between ESBL positive strains and ESBL negative strains, IBL positive strains and IBL negative strains, respecively. Results: In 163 enterobacteriaceae, ESBL positive rate was 11% (18 strains) and IBL positive rate was 17.2% (28 strains). The ESBL positive stains showed multiresistance to 9 of 12 β-lactam antibiotics with rates ranging from 33. 3 % － 100% and most of ESBL negative strains were only resistant to ampicillin, carbencillin and cefazolin. They are no significantly difference between the IBL positive strains and IBL negative strains on the resistance rates to 12 β－lactam antibiotics and promlts the routine susceptibility tests are not enough to reflect clinical resistant situations. Conclusion: As a result, The measurement of ESBL and IBL can supplement this deficiency and to instruct rational application of β-lactam antibiotics clinically.
出处
《现代中西医结合杂志》
CAS
2000年第9期772-774,共3页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
肠杆菌科细菌
ESBL
IBL
耐药性
Β-内酰胺类药物
enterobacteriaeae extended-spectrum β-lactamase induction β－lactamase β-lactam antibitics drug resistance
