产超广谱β-内酰胺酶革兰阴性菌对12种抗菌药物耐药性分析  

Drug Resistance Analysis on ESBLs-producing Gram-negative Bacilli to 12 Kinds of Antibacterial Drugs

作　　者：李真[1] 臧晓丽[2] 刘颖[1] 张亚莲[1] 

机构地区：[1]北京大学第四临床医学院北京积水潭医院,北京100035 [2]北京军区联勤部卫生部,北京100042

出　　处：《中华医院感染学杂志》2004年第2期217-219,共3页Chinese Journal of Nosocomiology

摘　　要：目的　分析产超广谱β 内酰胺酶 (ESBLs)革兰阴性菌对 12种抗菌药物的耐药情况及临床意义。方法　采用VITEKESBLs检测试验及双纸片协同试验 ,对从临床标本中分离的 2 0 4株革兰阴性菌作ESBLs的检测 ,比较12种抗菌药物对产ESBLs革兰阴性菌体外抗菌作用。结果　产ESBLs革兰阴性菌占全部分离菌的 2 3% ;其中多重耐药菌占 87 5 % ,亚胺培南及美罗培南对产ESBLs革兰阴性菌抗菌作用最强 ;头孢吡肟对产ESBLs阴性菌有较弱的抗菌作用 ;头孢西丁对产ESBLs肺炎克雷伯菌有强的抗菌作用 ;哌拉西林 /他唑巴坦对产ESBLs肺炎克雷伯菌及铜绿假单胞菌有较强的抗菌作用 ;氨基糖苷类抗生素对产ESBLs肺炎克雷伯菌有较强的抗菌作用 ;氧氟沙星对产ESBLs肺炎克雷伯菌呈现出较好的抗菌作用。结论　碳青酶烯类抗生素可作为产ESBLs阴性菌感染的首选治疗。OBJECTIVE To analyze the antibiotic resistance of ESBLs-producing Gram-negative bacilli to 12 kinds of antibacterial drugs. METHODS A total of 204 isolates from clinical specimens were screened for the presence of ESBLs by the VITEK ESBLs detection test and the double-disk synergy tests. In vitro antibacterial activity of 12 kinds of antibacterial drugs to ESBLs-producing Gram-negative bacilli were compared. RESULTS The detection rate of ESBLs was 23%. Of all ESBLs-producing bacilli,the productive rate of multi-resistant bacilli was 87.5%. Imipenem and meropenem had the most powerful antibacterial activity. Cefepime had weaker activity to ESBLs-producing bacilli. Cefoxitin, ofloxacin and aminoglycosides had powerful activity to ESBLs-producing Klebsiella pneumoniae. Piperacillin/tazobactam showed better activity to ESBLs-producing K. pneumoniae and Pseudomonas aeruginosa. CONCLUSIONS Carbapenem could be of the first choice to treat the infection caused by ESBLs-producing Gram-negative bacilli.

关 键 词：革兰阴性菌 超广谱Β-内酰胺酶 耐药性 

分 类 号：R978.1[医药卫生—药品]