2003-2006年医院感染大肠埃希菌与肺炎克雷伯菌的临床分布及耐药性分析  

Nosocomial Escherichia coli and Klebsiella pneumoniae Isolates in 2003-2006:Their Distribution and Resistance Analysis

作　　者：王震[1] 刘智成[1] 庄建伟[1] 汪海青 

机构地区：[1]镇江市第二人民医院检验科,江苏镇江212002

出　　处：《中华医院感染学杂志》2008年第4期581-583,共3页Chinese Journal of Nosocomiology

基　　金：镇江市社会发展基金资助项目(SH2005032)

摘　　要：目的分析大肠埃希菌和肺炎克雷伯菌的临床分布及其耐药性。方法细菌药敏试验采用纸片扩散法(K-B法);双纸片协同试验及纸片扩散确诊试验检测超广谱β-内酰胺酶(ESBLs);三维试验检测头孢菌素酶(AmpC酶)。结果ESBLs和AmpC酶的检出率分别为34.6%和5.0%;同时产ESBLs和AmpC酶的大肠埃希菌及肺炎克雷伯菌的分离率为2.4%;呼吸内科及泌尿外科住院患者的痰和尿液中ESBLs检出率较高;产ESBLs菌对美罗培南、亚胺培南以外的其他15种抗菌药物表现为不同程度耐药。结论产酶菌检出率逐年上升,耐药性不断增强,实验室应加强监测。OBJECTIVE To review and analyze the distribution and antimicrobial resistance of nosocomial Escherichia coli and Klebsiella pneumoniae.METHODS Disk diffusion test（Kirby-Bauer）was used for anti-microbial susceptibility.Extended spectrum β-lactamases（ESBLs）were detected by double disk synergy test and disk diffusion confirmatory test.AmpC enzyme was detected by the three dimensional assay.RESULTS The positive rate of the production of ESBLs and AmpC enzyme was 34.6% and 5.0%,respectively.The production rate of both ESBLs and AmpC enzyme positive was 2.4%.Isolated rate of ESBLs-producing strains in sputum and urine of the inpatients in respiratory ward and urinary ward was higher than others.All strains were 100% susceptible to meropenem and imipenem but resistant to 15 other antimicrobials in different degrees.CONCLUSIONS The isolated rate of β-lactamases-producing strains is increasing year by year.These strains are multi-drug resistant.Attention must be paid to their detection and surveillance.

关 键 词：大肠埃希菌 肺炎克雷伯菌 超广谱Β-内酰胺酶 AMPC酶 分布 耐药性 

分 类 号：R378.21[医药卫生—病原生物学]