185株临床分离肺炎克雷伯菌中超广谱β-内酰胺酶及耐药性检测  

Extended-spectrum β-Lactamases Production and Antibiotic Resistance in 185 Isolates of Klebsiella pneumoniae

作　　者：王鹏[1] 熊自忠[1] 王中新[2] 

机构地区：[1]安徽医科大学第一附属医院感染病科,安徽合肥230022 [2]安徽医科大学第一附属医院检验科,安徽合肥230022

出　　处：《中华医院感染学杂志》2009年第4期454-455,共2页Chinese Journal of Nosocomiology

基　　金：安徽省自然科学基金(050430804);安徽省优秀青年科技基金(08040106815)

摘　　要：目的了解临床分离肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)的发生率及其对常用抗菌药物的耐药性。方法采用CLSI表型确证试验-纸片增强法检测产ESBLs肺炎克雷伯菌,琼脂稀释法测定产ESBLs和非产ESBLs菌株对多种抗菌药物的敏感性。结果肺炎克雷伯菌中,产ESBLs菌株的发生率为41.1%,其对哌拉西林、头孢唑林、头孢呋辛、头孢噻肟、氯霉素、复方新诺明、氟喹诺酮类、阿米卡星的耐药显著;对亚胺培南和美罗培南的耐药率为0;对哌拉西林/他唑巴坦和头孢他啶的耐药率分别为26.3%、34.2%;除亚胺培南和美罗培南以外,产ESBLs菌株对其他抗菌药物的耐药率显著高于非产ESBLs菌株,差异有统计学意义(P<0.01)。结论临床分离肺炎克雷伯菌中,产ESBLs菌株发生率较高、多药耐药显著,应加强肺炎克雷伯菌中产ESBLs的发生率及其对抗菌药物耐药性进行检测和监测。OBJECTIVE To investigate the prevalence of extended-spectrum β-lactamases （ESBLs） and antibiotic resistance in Klebsiella pneumoniae isolates. METHODS ESBLs-producers were detected by CLSI phenotypic confirmatory test and susceptibilities were tested by agar dilution method. RESULTS 41. 1% Of isolates were ESBLs producers in those isolates. ESBLs producers were highly resistant to piperacillin, cefazolin, cefuroxime, fluoroquinolones, chloramphenieol, SMZ-TMP and amikacin. The resistant rate to piperaeillin-tazobaetam, and ceftazidime was 26.3% and 34. 2%. None was resistant to imipenem and meropenem in ESBLs producers. Except for carbapenems, the resistant rate to other antimicrobial agents was significantly higher in ESBLs producers than non ESBLs producers. CONCLUSIONS With resistance to most of antimicrobial agents, ESBLs-producers are highly prevalent in K. pneumoniae isolates, more attention should be paid to monitor these strains.

关 键 词：肺炎克雷伯菌 超广谱Β-内酰胺酶 耐药性 

分 类 号：R378.996[医药卫生—病原生物学]