ESBL阳性大肠埃希菌AmpC酶的检测及其耐药分析  

Detection of AmpC β-lactamase and Analysis of Antimicrobial Resistance to the E.Coli of ESBL Producer

作　　者：王小兰[1] 林立中[1] 夏先考[1] 

机构地区：[1]湖南省常德市第一人民医院检验科,湖南常德415003

出　　处：《医学临床研究》2006年第12期1930-1931,1934,共3页Journal of Clinical Research

摘　　要：【目的】检测ESBL阳性大肠埃希菌的AmpC酶,了解其耐药情况,以指导临床合理用药。【方法】利用头孢西丁初筛试验、三维确证试验检测受试菌的AmpC酶;双纸片增效法确证ESBL大肠埃希菌;采用天地人生化药敏试验卡进行鉴定和药敏试验;用WHONET5.3软件对药物敏感试验数据进行统计分析。【结果】经过ESBL确诊的684份阳性大肠埃希菌中,AmpC酶的检出率为10.4%(71株);ESBL阳性与ESBL阴性大肠埃希菌相比较其对,喹诺酮类、氨基糖甙类、磺胺类的耐药性差异存在显著性(P<0.05);ESBL、AmpC酶二者阳性株与仅为ESBL阳性株者相比以上三类抗生素耐药性差异无显著性(P>0.05),但二者在青霉素类加酶抑制剂,头孢三代加酶抑制剂的耐药性进行比较,则有显著性差异(P<0.05)。【结论】进行ESBL阳性大肠埃希菌AmpC酶的检测及其耐药监测,可以指导临床合理使用抗生素,减缓细菌耐药。[Objective]To detect AmpC β-lactamase in the E. coli of ESBL producer and survey its antibiotics resistance in order to select antibiotics correctly according the results. [Methods]The AmpC β-lactamase producing status of ESBL producers was detected with modified three dimensional test and screening test. Double antimicrobial agents were used to detect ESBL confirmatory test. “TianDIRen”was used to study the antimicrobial resistances and bacteria indentification. The data were analyzed by WLAONET 5. 3 software. [Results]Among 684 ESBL producers , the total positive rate of AmpC β-lactamase was 10.4%. Between the positive strains for ESBL and the negative strains , there were some significant antimicrobial resistance differences（ P〈0.05） ; as for the aminoglycosides , fluoroquinolones, trimethoprim sulfamethoxasole, comparing both positive strains for ESBL and AmpC β-lactamase with the only positive strains for ESBL; there were no obvious differences for the above three kinds of antibiotics. However, there were some significant differences（ P〈0.05） among the Beta-lactam/beta-lactamase inhibitor combinations. [Conclusion]It＇s necessary to detect AmpC-β-1actamase and survey antibiotics resistance for correct selection of antibiotics.

关 键 词：大肠杆菌 抗生素类 内酰胺 药物耐受性 

分 类 号：R453[医药卫生—治疗学]