286株肠杆菌科菌β-内酰胺酶及其耐药性的研究  

β-Lactamases and Resistance of 286 Strains of Enterobacteriaceae Isolated from Teaching Hospitals in China

作　　者：徐英春[1] 王澎[1] 陈民钧[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院,北京100730

出　　处：《中华医院感染学杂志》2004年第4期447-449,共3页Chinese Journal of Nosocomiology

摘　　要：目的　检测 2 86株肠杆菌科菌持续高产AmpC酶和超广谱 β 内酰胺酶 (ESBLs) ,并测定 12种抗菌药物体外抗菌活性。方法　采用三维法测定AmpC和ESBLs及纸片扩散法测定 12种抗菌药物的抑菌环直径。结果　对不产两类酶 5 6株菌 ,亚胺培南 (IPM )、头孢吡肟 (FEP)和哌拉西林 /他唑巴坦 (TZP)的耐药率分别为1 8%、2 1 4 %和 35 7% ;对单产AmpC 81株菌 ,IPM没有耐药菌株 ,FEP和TZP耐药率分别为 4 9%和 5 6 8% ;对产两类酶 4 5株菌 ,未见IPM耐药菌株 ,FEP和TZP的耐药率分别为 2 0 0 %和 4 1 9% ;对单产ESBLs 10 4株菌 ,未见IPM耐药菌株 ,FEP和TZP耐药率分别为 2 0 2 %和 2 5 0 %。结论　FEP和IPM对单产AmpC酶的菌株有好的抗菌活性 ,FEP对产两类酶和不产酶的菌株抗菌活性比IPM低 ,但比其他抗生素活性高。OBJECTIVE To detect the stably derepressed expression of AmpC β-lactamases(AmpC) and extended spectrum β-lactamases(ESBLs) of 286 strains of Enterobacteriaceae, and antimicrobial activities in vitro of 12 antibiotics against the strains producing different kinds of β-lactamases. METHODS AmpC and ESBLs were detected by three dimensional extract test, and the zone diameters of 12 antibiotics were tested by disk diffusion method. RESULTS Against the 56 strains producing neither AmpC nor ESBLs, antimicrobial susceptibility tests showed that 1.8%, 21.4% and 35.7% of the strains were resistant to imipenem(IMP), cefepime(FEP), and piperacillin/tazobactam(PTZ), respectively. Against 81 strains producing merely AmpC, none was resistant to IMP, 4.9% and 56.8% of the strains were resistant to FEP and PTZ, respectively. Against 45 strains producing both enzymes, no resistant strain was detected to IMP, 20.0% and 41.9% of the strains were resistant to FEP and PTZ, respectively. Against 104 strains producing single ESBLs, none was resistant to IMP, 20.2% and 25.0% of the strains were resistant to FEP and PTZ. CONCLUSIONS FEP and IMP exhibit higher antimicrobial activities than other 10 antibiotics against the strains producing single AmpC. FEP has lower antimicrobial activities than IMP against the strains producing both AmpC and ESBLs or those producing none of the two enzymes, but has higher antimicrobial activities than other antibiotics.

关 键 词：头孢吡肟 持续高产AMPC酶 超广谱Β-内酰胺酶 

分 类 号：R378.2[医药卫生—病原生物学]