摘要
目的 分析本地区 2 0 0 0年 1月～ 2 0 0 3年 6月间产超广谱 β-内酰胺酶 (ESBL s)肺炎克雷伯菌、大肠埃希菌耐药性的变化 ,为临床合理选用抗菌药物提供依据。方法 应用回顾性调查分析方法对该期间临床标本分离的肺炎克雷伯菌及大肠埃希菌产与非产 ESBL s菌株的培养和药敏试验数据进行对比统计分析。结果 所分离出的 344株肺炎克雷伯菌中 ,产 ESBL s的有 15 4株 ,占 4 5 .2 % ;大肠埃希菌 4 5 4株中 ESBL s阳性 2 0 1株 ,占 4 3.4 % ,呈逐年升高的趋势 ;产 ESBL s的肺炎克雷伯菌及大肠埃希菌对青霉素类、头孢菌素类、单环 β-内酰胺类、氨基糖苷类、喹诺酮类、以及加 β-内酰胺酶抑制剂复合抗生素 ,如氨苄西林 /舒巴坦、阿莫西林 /克拉维酸、替卡西林 /克拉维酸等抗菌药物呈多重耐药 ;显著高于非产 ESBL s的菌株 (P<0 .0 0 1) ;但对亚胺培南高度敏感。结论 本地区肺炎克雷伯菌及大肠埃希菌产 ESBL s的阳性率高 ,临床治疗中应严格掌握抗菌药物应用指征 ,并动态监测其耐药性变迁 ,防止 ESBL s肺炎克雷伯菌及大肠埃希菌的局部流行。
OBJECTIVE To investigate the trend of antibacterial resistance rate of extended-spectrum β-lactamases (ESBLs) producing K. pneumoniae and E. coli in Guangzhou area from Jan 2000 to Jun 2003,for the guidance of rational use of antibacterials. METHODS K. pneumoniae and E. coli had been isolated from clinical samples and antibiotic resistance in either ESBLs producing or non-producing strains were analyzed and studied retrospectively. RESULTS A total of 154 strains of K. pneumoniae were considered ESBLs,the positive rate was 45.2%. From E. coli 201 strains considered ESBLs,the positive rate was 43.2% and the elevated mode by years was shown. The ESBLs-producing strains displayed multi-drug resistance to penicillins,cephalosporins,monobactams,aminoglycosides,quinolones and ampicillin/sulbactam,amoxicillin/clavulanic acid,ticarcillin/clavulanic acid,et al . The resistance was significantly higher than that of ESBLs non-producing strains ( P <0.001). But both of them were still highly sensitive to imipenem. CONCLUSIONS The positive rates of ESBLs producing K. pneumoniae and E. coli in our area are high and multi-drug resistance is serious. In order to prevent the ESBLs producing K. pneumoniae and E. coli infection outbreak,more sputum culture and drug sensitivity should be emphasized before medication.
出处
《中华医院感染学杂志》
CAS
CSCD
2004年第5期492-495,共4页
Chinese Journal of Nosocomiology
基金
广州市科技局科研项目 (编号 :2 0 0 1- Z- 0 6 4 - 0 1- 2 )
