摘要
目的 了解合肥地区产超广谱 β 内酰胺酶 (ESBL)的肺炎克雷伯菌、大肠埃希菌分布及耐药特点。方法 应用纸片扩散法对合肥地区 4家较大的综合性医院从临床标本中分离的 2 5 4株肺炎克雷伯菌和大肠埃希菌进行ESBL的确诊试验。结果 2 5 4株大肠埃希菌和肺炎克雷伯菌共检出6 9株产ESBL菌株 (2 7 2 % ) ,其中 ,血液感染ESBL检出率为 5 4 5 % (6 / 11)、烧伤科ESBL的检出率为 48 6 % (18/ 37)。亚胺硫霉素对产ESBL的大肠埃希菌和肺炎克雷伯菌的敏感率分别为 94 5 %和 80 %。头孢哌酮 /舒巴坦、哌拉西林 /他唑巴坦和头孢西丁对产ESBLs的大肠埃希菌和产ESBLs的肺炎克雷伯菌的敏感率在 40 %～ 70 %之间 ,阿米卡星对产ESBL的大肠埃希菌的敏感率为 6 9 2 %。结论 ESBL在血液感染和烧伤科标本中的检出率较高。治疗产ESBL菌株引起的感染可首选亚胺硫霉素 ,其次 ,选含酶抑制剂的复方制剂和头霉素类。对产ESBL的大肠埃希菌也可选阿米卡星。
Objective\ To determine the distribution of strains producing ESBL among Klebsiolla pneumoniae and E.coli, and investigate the antibiotic resistance of these strains. Methods\ 254 strains K. pneumoniae and E.coli from isolating culture samples were collected from four large hospitals in Hefei area, and these strains were determined by disc conformatory test for ESBL. Results\ 69 strains(27.2%) were determined to produce ESBL among 254 strains. The positive rates of blood infection and department of burn were 54.5% and 48.6% respectively. The susceptibility of ESBL-producing E.coli and K.pneumoniae strains to imipenem were 94.5% and 80%, and to cefoperazone/sulbactam, pipercillin/tazobactm, cefoxitin ranged from 40%～70%. Amikacin had the sensitive rate of 69.2% to E.coli. Conclusion\ Blood infection and samples from department of brun had the higher positive rates of ESBL. To treat infections caused by ESBL, imipenem is the best choice, the next may be β-lactamase inhibitor combinations and cefoxitin. To deal with the ESBL-producin E.coli amikacin can be used also.
出处
《安徽医科大学学报》
CAS
2001年第1期62-64,共3页
Acta Universitatis Medicinalis Anhui
