2003-2005年我院呼吸科革兰阴性杆菌产ESBLs菌株检测及耐药性分析  

Detection of Extended-spectrum Beta-lactamases and Resistance in Gram-negative Bacilli Isolates in Department of Respiratory During 2003～2005 in Our Hospital

作　　者：所鸿[1] 张志敏[2] 董京生[1] 

机构地区：[1]内蒙古医学院附属医院呼吸内科,内蒙古呼和浩特010050 [2]内蒙古医学院附属医院检验科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2008年第3期267-270,共4页Inner Mongolia Medical Journal

摘　　要：目的：了解我院呼吸科住院患者痰检阳性的革兰阴性杆菌产超广谱β-内酰胺酶（ESBLs）的检出率及耐药情况,为临床用药提供参考。方法：对2003年1月~2005年12月我院呼吸科住院患者痰检阳性的革兰阴性杆菌用NCCLS表型确证试验检测ESBLs的检出率;用纸片扩散法进行药敏试验,按NCCLS 2003年版标准判断结果,同时对结果进行回顾性分析。结果：3年中分离出692株革兰阴性杆菌,其中大肠埃希菌、阴沟肠杆菌以及肺炎克雷伯杆菌属单检产ESBLs菌株检出率分别为23.8%、20.0%和23.5%;产ESBLs菌株对除碳青酶烯类之外抗菌药物耐药率明显高于非产酶菌株,产酶菌株对亚氨培南、头孢哌酮/舒巴坦敏感性好,对阿米卡星、左氧氟沙星次之,对三代头孢高度耐药。结论：产ESBLs菌株的增多是革兰阴性杆菌耐药的重要原因之一,临床应加强细菌耐药性的监测及ESBLs的检测,合理应用抗菌素,以防止ES-BLs菌株的产生。Objective： To investigate the resistance and extended- spectrum β- lactamases（ESBLs） in gram- negative bacilli isolates, which were isolated from patients with lower respiratory tract infection in department of respiratory medicine during 2003--2005 in our hospital. Methods： ESBLs production was dected by NCCLS phenotypic confirmatory test in gram - negative bacilli isolates. Antibiotic susceptibility was tested by Kirby- Bauer method. The results were interpreted according to NCCLS 2003. Results： A total of 692 strains of gram-negative bacilli isolates. The prevalence of ESBLs was 23.8% Escherichia coli, 20.0% Enterobacter cloacae and 23.5 % Klebsiella pneumoniae. All ESBLs producing strains were susceptible to imipenem. The resistance rate of to most antibiotics was much higher than those of non - ESBLs producing strains. The susceptibilty rate of ESBLs producing strains to imipenem and cefoperazonesulbactam were higher than other antimicrobial agents. Conclusions：The increase in ESBLs positive pathogens is one of the reasons for higher resistance. Surveillance of resistance and ESBLs detection are of great importance to both rational use of antibiotics and control of ESBLs producers

关 键 词：下呼吸道感染 革兰阴性杆菌 超广谱Β-内酰胺酶 耐药性 抗菌素 

分 类 号：R562[医药卫生—呼吸系统]