303株产超广谱β-内酰胺酶阳性菌分布及对常用抗菌药物的耐药性分析  

ANALYSIS ON THE DISTRIBUTING OF 303 STRAINS OF EXTENDED SPECTRUM β-LACTAMASES BACTERIA AND THEIR DRUG RESISTANCE AGAINST COMMONLY USED ANTIBACTERIALS

作　　者：郭珊[1] 马茹[1] 许世琴[1] 

机构地区：[1]河南新乡市中心医院,新乡453000

出　　处：《现代预防医学》2007年第17期3254-3255,3258,共3页Modern Preventive Medicine

摘　　要：[目的]了解303株产超广谱β-内酰胺酶阳性菌(ESBLs)的种类、分布及对12种常用抗菌药物的耐药性分析,以指导临床合理应用抗菌药物,预防和控制产ESBLs阳性菌感染的暴发流行。[方法]对我院2003年1月～2005年12月间从临床送检的各类标本中分离的大肠埃希菌和肺炎克雷伯菌用双纸片协同法筛选产超广谱β-内酰胺酶阳性菌株,采用纸片扩散法比较亚胺培南等12常用抗菌药物对产ESBLs耐药菌体外抗菌作用。[结果]3年中大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶(ESBLs)的发生率呈逐年上升的趋势。从2003～2005年大肠埃希菌和肺炎克雷伯菌总的ESBLs发生率分别为23.31%、31.1%和43.2%,产ESBLs菌对头孢菌素类、氨基糖苷类、喹诺酮类等抗菌药物呈多重耐药,但对亚胺培南高度敏感。[结论]产ESBLs菌的日益增多,与患者病情严重,长期使用广谱高效抗生素,免疫功能低下等因素有关。因此,应严格控制广谱抗生素的应用,同时广泛开展超广谱β-内酰胺酶的监测,是预防和控制ESBLs菌感染的重要措施。[Objective] To analyze the category and distribution of 303 strains of extend-spoctrum β-lactamases （ES- BLs） germs and their drug resistance against 12 kinds of commonly used antibacterial drugs, so as to instruct rational use of antibiotics in clinic, prevent and control the outbreak of extend-spectrum β-1actamases germs. [ Methods] By the method of double-disc synergy test, the strains with extend-spectrum β-1actamases positive were separated front Escherichia coil and Klebsiella isolated from all kinds of clinical samples from January, 2003 to December, 2005. Then their antibacterial activity against 12 kinds of commonly used antibacterial drugs （ Imipenem and so on） in vitro was assessed by using Kirby-Bauer method. [Results] The incidence rate of Escherichia coli and Klebsiella producing extend-spectrum β-1actamases in the three years increased yearly. From 2003 to 2005, the incidence rate was 23.21%, 31.1% and 43.2%, respectively. Extend-spectrum β-1actamases germs showed mtdti-drug resistance to the cephalosporins, aminoglycosides, quinolones and many other antibiotics, but were hypersensitive to Imiponem. [Conclusions] Extend-spoctnml β-1actamases germs are more and more, which is associated with the severity of disease, long-term use of broad-spectrum antibiotics and low immunologic function. So strictly controlling the use of bread-spectrum antibiotics and developing extensive surveillance on extend-spectrum β-1actamases are key measures for preventing and controlling extend-spectrum β-1actometers germs infection.

关 键 词：超广谱β-内酰胺酶(ESBLs) 抗菌药物 耐药性 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]