临床分离的191株产超广谱β-内酰胺酶细菌耐药性研究  

In vitro Susceptibility of 191 Clinical Isolated Strains of ESBLs Positive Bacteria

作　　者：曹月升[1] 陆春雨[1] 冯志山[1] 杨春秀 张立志[1] 

机构地区：[1]河北省人民医院,河北石家庄050051 [2]武警河北总队医院,河北石家庄050081

出　　处：《中华医院感染学杂志》2004年第9期1067-1071,共5页Chinese Journal of Nosocomiology

摘　　要：目的　了解本地区产超广谱β-内酰胺酶 (ESBL s)细菌的检出率、细菌类型、对抗菌药物的敏感性 ,特别是探讨提高头孢曲松对该细菌抗菌活性的可行办法。方法　对从临床患者标本中分离出的 5 74株革兰阴性杆菌进行产 ESBL s菌株检测、药敏实验 ,并对 191株产 ESBL s细菌进行耐头孢曲松加不同比例的酶抑制剂的敏感实验。结果　在 5 74株临床分离的革兰阴性菌中 ,共检出 ESBL s细菌 191株 ,检出率为 33.2 8% ,其中以不动杆菌属的检出率最高 ,为 4 3.2 2 % ,其次为大肠埃希菌、克雷伯菌属 (肺炎克雷伯菌、产酸克雷伯菌 ) ;产 ESBL s细菌对抗菌药物的耐药性明显高于非产 ESBL s细菌 ;头孢曲松 /克拉维酸 2∶ 1复合制剂抗菌效果最佳。结论　各地区ESBL s产生率最高的菌种虽有差异 ,但均为临床治疗比较棘手、极易造成医院感染暴发流行的重要致病菌 ;合理使用抗菌药物及酶抑制剂对治疗疾病和控制医院感染的发生至关重要 ,把对 ESBLOBJECTIVE To investigate the clinical isolated strains of ESBLs positive bacteria for the rate of occurrence, species distribution and susceptibility to antibiotics, and to look for a practical method to improve the (antibacterial) activity of ceftriaxone to ESBLs positive bacteria. METHODS A total of 574 clinical isolates of Gram-negative bacilli were tested for ESBLs and antimicrobial susceptibility testing was done. Then the (antimicrobial) susceptibility of ceftriaxone added different dose of β-lactamase inhibitor to 191 ESBLs positive strains was evaluated. RESULTS From them 191 clinical isolates of Gram-negtive bacilli produced ESBLs, with a percentage of 33.28%. Detected rate of Acinetobacter was the highest: 43.22%, then Escherichia coli and (Klebsiella.) The resistance rate of ESBLs positive strains to antibiotics was higher than that of ESBLs negative ones. The antibacterial activity of ceftriaxone/clavulanic acid (2∶1) was the best. CONCLUSIONS Though the species distribution of ESBLs positive bacteria is different in different geographycal areas, they are important pathogens to cause nosocomial infection. Rational administration of antibiotics is critical to anti-infection treatment and (nosocomial ) infection control. Routinely detection of ESBLs is necessary.

关 键 词：超广谱Β-内酰胺酶 医院感染 药敏实验 

分 类 号：R969.3[医药卫生—药理学]