小婴儿细菌性肺炎超广谱β-内酰胺酶的临床探讨  

Clinical Study of ESBLs in Infant Bacterial Pneumonia

作　　者：陈波[1] 谢永武[1] 周彬[1] 陈蓉蓉[1] 

机构地区：[1]广东省珠海市妇幼保健院儿科,广东珠海519000

出　　处：《河北医学》2008年第1期10-13,共4页Hebei Medicine

摘　　要：目的：了解产超广谱β-内酰胺酶（ESBLs）株在1-4月婴儿细菌性肺炎中的发生率及对抗生素的耐药情况。方法：以双纸片法检测ESBLs，kirby-Bauer（KB）法测定细菌对抗菌药物的耐药性。结果：2005-2006年肺炎克雷伯菌和大肠埃希菌的ESBLs的总发生率为32．1％和35．3％。ESBLs的发生率在重症肺炎中的发生率明显高于轻症肺炎，产ESBLs株对头孢菌素类抗生素呈高度耐药状态，且逐年上升，对亚胺培南耐药株未发现，头孢菌素＋β-内酰胺酶抑制剂，对产ESBLs株仍有较强的抗菌效果。结论：小婴儿细菌性肺炎中产ESBLs菌株已相当高，重症细菌性肺炎更为显著，肺炎克雷伯菌和大肠埃希菌是产ESBLs的主要菌株。临床上要合理使用抗生素，避免滥用第3代头孢菌素，以有效控制产ESBLs细菌的产生，治疗ESBLs引起的感染以碳青霉烯类最佳。Objective： To study the incidence of ESBLs - producing stains in infant bacterial pneumonia and incidence of antibiotic resistance. Method： ESBLs was assessed by test double - disc , the bacterial drug resistance was assessed by K - B disc diffusion. Result： 2005 - 2006, the incidence of ESBLs - producing stains in Klebsiella and Escherichia coil was 32.1% and 35.3% respectively, the incidence of ESBLs - producing stains in severe pneumonia was significantly higher than that of mild pneumonia. The drug resistance to cephalosporins in ESBLs - producing stains was high, and increasingly year by year, but the drug resistance to carbapenem was not found. Conclusion ： ESBLs - producing strains of ESBLs in infant bacterial pneumonia has been very high, severe bacterial pneumonia more markedly. Klebsiella and Escherichia coil is the predominant strain of ESBLs. To be reasonable on the clinical use of antibiotics to prevent abuse of third - generation cephalosporins, so as to effectively control the formation of ESBLs - producing bacteria, carbapenem is first selected to treat infections caused by ESBLs - producing bacteria.

关 键 词：超广谱Β-内酰胺酶 肺炎克雷伯菌 大肠埃希菌 细菌性肺炎 耐药性 

分 类 号：R725.6[医药卫生—儿科] R446.5[医药卫生—临床医学]