碳青霉烯类是治疗产ESBLs细菌感染的最佳抗生素  

Carbapenem,the Best Antibiotic for Treatment of ESBLs-producing Bacterial Infection

作　　者：朱夫俊 李珍大[2] 史利宁[2] 张小卫[2] 王卫萍[2] 邵海枫[2] 

机构地区：[1]安徽省阜南县人民医院,阜南236300 [2]南京军区南京总医院,南京210002

出　　处：《江苏药学与临床研究》2005年第5期67-68,共2页Jiangsu Pharmacertical and Clinical Research

摘　　要：目的调查临床标本分离的产ESBLs大肠埃希菌和肺炎克雷伯菌的耐药性,证实碳青霉烯类是治疗产ESBLs细菌感染的最佳抗生素.方法按照NCCLS推荐的纸片确证法检测产ESBLs菌株,以K-B纸片扩散法进行药敏试验.结果临床标本分离的产ESBLs菌株,大肠埃希菌335株、肺炎克雷伯菌129株,产酶率分别占45.03%(355/744)、28.86%(129/477).产ESBLs组细菌对环丙沙星、氨苄西林、头孢唑林、头孢噻肟、头孢他啶、头孢吡肟等临床常用的抗菌药物的耐药率高达92%～100%;对亚胺培南/西司他丁、美罗培南2种碳青霉烯类抗生素的耐药率均在1%以下.结论本组实验证明,碳青霉烯类抗生素是治疗产ESBLs细菌感染的最佳选择.AIM To investigate the antimicrobial resistance of ESBLs-producing E. coli and K. pneumoniae isolated from clinical specimen,and prove that carbapenm is the best antibacterial agent for treatment of ESBLs-producing strains infection. METHODS ESBLs- producing isolates were detected by the NCCLS recommended disc diffusion confirmatory test and the bacterial susceptibility test was done by K- B method.RESULTS Among ESBLs-producing strains obtained from clinical specimen, 355 strains were E. coil and 129 strains were K. pneumoniae.. The incidence of ESBLs in E. coil and K. pneumoniae isolates was 45.03 % （355/744） and 28.86 % （129/477）, respectively. The resistant rates of ESBLs-producing bacteria to commonly used antibiotics such as ciprofloxacin, ampicillin, cefazolin, cefotaxime, ceftazidime, cefepime etc were than 92 %, and tesisitant rates to imipemen and meropenem were less than 1%. CONCLUSION Carbapenem is the best antibiotics for treatment of ESBLs-producing bacterial infection.

关 键 词：亚胺培南/西司他丁 美罗培南 超广谱Β-内酰胺酶 大肠埃希菌 肺炎克雷伯菌 

分 类 号：R915[医药卫生—微生物与生化药学]