沙雷菌属耐药现状及β-内酰胺酶检测  

Antibiotic Resistance and β-Lactamases Detection of Serratia

作　　者：周田美[1] 董晓勤[1] 俞云松[2] 王杰[2] 余道军[1] 周志慧[2] 

机构地区：[1]杭州市第一人民医院,浙江杭州310006 [2]浙江大学医学院附属第一医院,浙江杭州310003

出　　处：《中华医院感染学杂志》2005年第1期103-105,共3页Chinese Journal of Nosocomiology

基　　金：杭州市医药卫生科技计划项目(02A014)

摘　　要：目的了解本地区沙雷菌属耐药现状及AmpC酶、超广谱β内酰胺酶(ESBLs)检测率,为临床治疗感染性疾病提供理论依据。方法采用KB法对148株沙雷菌属进行药敏试验,用表型筛选及三维试验法检测AmpC酶及ESBLs。结果148株沙雷菌属对氨苄西林、头孢呋辛、阿莫西林/克拉维酸耐药率>80%,亚胺培南、头孢吡肟、复方新诺明、环丙沙星等抗菌药物耐药率均<10%,头孢西丁耐药率31.1%;148株沙雷菌属中产AmpC酶菌占12.2%(18株),同时产AmpC酶及ESBLs菌占2.7%(4株);产酶菌对多种抗生素耐药。结论本地区沙雷菌属耐药性的产生主要是细菌产生AmpC酶及ESBLs引起的,以AmpC酶为主,临床应根据药敏试验结果合理用药。OBJECTIVE To investigate the Serratia′s resistance in Hangzhou and the detection rates of AmpC ~β-lactamase (AmpC) and extended-spectrum β-lactamases (ESBLs), which would help treat infectious diseases in clinic. METHODS The drug sensitivity test of 148 strains of Serratia was done by Kirby-Bauer test. The ~AmpC enzymes and ESBLs were detected by phenotype screening and three-dimensional tests. RESULTS Among 148 strains of Serratia, the resistant rates to ampicillin, cefuroxime, amoxicillin/clavulanate were above 80%, and to imipenem, cefepime, trimethoprim/sulfamethoxazole, ciprofloxacin and other antibiotics were below 10%, while to cefoxitin was 31.1%. There were 18 strains (12.2%) producing AmpC enzymes, and 4 strains ^(2.7%) producing AmpC enzymes and ESBLs simnltaneously. The enzyme-produced strains were resistant to many antibiotics. CONCLUSIONS The producing of AmpC enzymes and ESBLs leads to the Serratia′s resistance to many antibiotics in Hangzhou, and the strains producing AmpC enzymes are more than that producing ESBLs. The antibiotics should be used reasonably according to the results of drug sensitivity test in clinic.

关 键 词：沙雷菌属 Β-内酰胺酶 耐药性 

分 类 号：R378.99[医药卫生—病原生物学]