超广谱β-内酰胺酶细菌耐药性调查  

Analysis on resistance of strains producing extended-spectrum beta-lactamases

作　　者：孙杰[1] 于笑难[2] 傅炜昕[2] 杨婧[2] 

机构地区：[1]辽宁阜新市中心医院,123000 [2]沈阳军区总医院

出　　处：《中国公共卫生》2004年第4期484-485,共2页Chinese Journal of Public Health

摘　　要：目的　分析 134株超广谱 β -内酰胺酶菌株的耐药性 ,以利于药物治疗。 方法　应用双纸片协同试验鉴定超广谱 β-内酰胺酶菌株 ,琼脂稀释法检测超广谱 β-内酰胺酶细菌的最低抑菌浓度 (MIC)。 结果　亚胺培南敏感率 85 8% ,10 7株菌的MIC在 0 12 5～ 4 0 μg/ml之间 ,美洛培南敏感率 94 0 % ,12 6株菌的MIC在 0 12 5～ 4 0 μg/ml之间 ;头孢哌酮 /舒巴坦敏感率 4 0 3% ,4 4株菌的MIC在 0 12 5～ 16 0 μg/ml之间 ;哌拉西林 /他唑巴坦敏感率5 6 0 % ,5 9株菌的MIC在 0 12 5～ 16 0 μg/ml之间 ;头抱西丁敏感率 4 7 0 % ,6 3株菌的MIC在 0 12 5～ 8 0 μg/ml之间 ;左氧氟沙星敏感率 6 1 9% ,83株菌的MIC在 0 12 5～ 2 0 μg/ml之间 ;环丙沙星敏感率 5 3 7% ,72株菌的MIC在0 12 5～ 1 0 μg/ml之间 ;丁胺卡那霉素敏感率 6 4 2 % ,86株菌的MIC在 0 12 5～ 8 0 μg/ml之间 ;氯霉素、头孢噻肟、头孢吡肟、氨曲南敏感率均在 4 0 0 %以下。结论　抗菌活性最好的是碳青霉烯类药物 ,加酶抑制剂的头孢哌酮 /舒巴坦、哌拉西林 /他唑巴坦中介耐药增加 ,主要原因是临床过度使用所致 ,喹诺酮类抗生素对大肠埃希菌以外的细菌抗菌活性较好。Objective To analyse the resistance of strains producing ESBLs so as to give a better medicine therapy.Methods Strains produing ESBLs were identified by double-disk synergy test and their MIC were detected by agar dilusion test.Results The sensitivity of Imipenem was 85.8% and MIC was between 0.125-4.0μg/ml;Meropenem 94.0% and 0.125-4.0μg/ml .They had shown good antibiotic activity.Cefoperazone/Sulbactam 40.3%,MIC at 0.125-16.0μg/ml (44 strains);Piperacillin/tazobactam 56.0%,MIC 0.125-16.0μg/m(59 strains);Cefoxitin 47.0%,MIC 0.125-8.0 μg/ml(63 strains);Levofloxacin 61.9%,MIC 0.125-2.0μg/ml(83 strains);Ciproaoxacin 53.7%,MIC 0.125-1.0 μg/ml(72 strains);Amikacin 64.2%,MIC 0.125-8.0 μg/ml(86 strains);Chloramphenicol,Cefotaxime,Cefepime and Aztreonam all below 40.0%.Conclusions Carbapenems had the best antibiotic activity.There were increases of intermediate resistane for Cefoperazone/sulbaetam and Piperacillin/tazobactam which have enzyme inhibitor.They have been overused in clinical may be the main reason.Quinolones have better antibiotic activity on bacteria except for Escherichia coli.

关 键 词：超广谱Β-内酰胺酶 琼脂稀释法 最低抑菌浓度(MIC) 

分 类 号：R378.11[医药卫生—病原生物学]