摘要
目的了解产ESBLs菌株的流行现状,依照新版CLSI文件指导原则对产ESBLs菌株的耐药性进行分析,为临床治疗产ESBLs菌株感染提供依据。方法收集笔者所在医院2010年8月～2011年12月临床标本中分离的大肠埃希菌和肺炎克雷伯菌,采用DL-96细菌测定系统进行检测分析。结果大肠埃希菌ESBLs检出率为64.8%,肺炎克雷伯菌ESBLs检出率为31.6%;在药敏方面,依照新版CLSI文件指导原则,产ESBLs菌株对头孢他啶、头孢吡肟、氨曲南的敏感结果不再报为耐药;产ESBLs菌株对碳青霉烯类仍具有极高的敏感率;对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢西丁、阿米卡星、美满霉素的敏感性较好;对氟喹诺酮类、阿莫西林/克拉维酸、氨苄西林/舒巴坦、磺胺甲恶唑/甲氧苄啶、庆大霉素、四环素的敏感性差。结论抗菌药物的不合理应用,使产ESBLs菌株大量出现,而新版CLSI文件指导原则为临床治疗产ESBLs菌株感染,使用敏感的头孢菌素和氨曲南提供了依据,临床上应提高感染性疾病标本的送检率,依据药敏结果,科学合理使用抗生素。
Objective Understanding of ESBLs strains of epidemic situation,in accordance with the new version of the CLSI file guiding principle for the ESBLs producing strains resistant to undertake an analysis,for the clinical treatment of ESBLs strain infection. Methods The hospital in August 2010 - December 2011 were collected in clinical specimens of Escherichia coli isolated from Borrelia bacteria pneumonia and cray, using DL-96 bacterial assay system for detection and analysis. Results Escherichia coli ESBLs detection rate of 64.8%, cray Borrelia bacteria pneumonia ESBLs positive rate was 31.6%;in susceptibility,in accordance with the new version of the CLSI file guiding principle, produce ESBLs strains of ceftazidime,cefepime, ammonia song south sensitive results in longer to resistance;ESBLs strains to carbapenems still has a very high sensitivity rates; on piperacillin/tazobactam,cefoperazone/shu TAZ,cefoxitin, amikacin, minocycline sensitivity is better;the fluoroquinolones,amoxicillin/clavulanic acid,ampicillin/shu TAZ, sulfamethoxa-zole/trimethoprim,gentamicin,tetr- acycline sensitivity difference. Conclusion Unreasonable application of antibiotics,so that ESBLs strains appeared in large numbers,and a new version of the CLSI file guiding principles for clinical treatment of ESBLs strain infection,use of sensitive to cephalosporin and ammonia song south provided a basis,clinical should improve infectious disease specimen examination rate, according to drug susceptibility results,scientific and rational use of antibiotics.
出处
《中国医药科学》
2012年第13期54-56,共3页
China Medicine And Pharmacy
