志贺菌产ESBLs酶的检测及其耐药性分析  

Detection and drug resistance of ESBLs-producing Shigella

作　　者：边锋芝[1] 苑广盈[1] 孙玉国[1] 张延芳[1] 李金文[1] 

机构地区：[1]山东省济南市第四人民医院检验科,250031

出　　处：《国际检验医学杂志》2009年第5期449-450,453,共3页International Journal of Laboratory Medicine

摘　　要：目的了解本地区产超广谱β-内酰胺酶(ESBLs)志贺菌的检出率以及耐药情况,为临床治疗菌痢提供试验依据。方法E-test试验进行ESBLs志贺菌的检测,改良三维试验检测AmpC酶,K-B纸片扩散法进行药敏试验,用WHONET5.4软件进行数据分析。结果275株志贺菌中,产ESBLs志贺菌12株,检出率为4.4%,未检测出产AmpC酶菌株。产ESBLs组对第1代、第2代、第3代头孢菌素和氨曲南耐约性均明显高于非产ESBLs组,氨苄西林、氯霉素、四环素、复方新诺明耐药率在两组均有较高水平,对亚胺培南、头孢西丁、环丙沙星、庆大霉素较敏感。结论本地区ESBLs志贺菌检出率虽然较低,但已经有院内感染向社区感染转化的趋势,应引起重视,合理使用抗菌药物至关重要。Objective To investigate the detection rate and drug resistance of extended-spectrum β-lactamases （ESBLs）-producing Shigella in the district,in order to provide a guidance to clinical rational use of antibiotics. Methods ESBLs were detected by E-test,and AmpC was detected by the modified three-dimensional test; disc diffusion test （K-B method） was used to study the drug resistance of Shigella isolated from clinical specimens. The date analysis was performed with WHONET5.4 software. Results In 275 strains of Shigella,12 strains （4.4%） of ESBLs-producing Shigella were de- tected consider ESBLs, and no AmpC-producing strain was found in Shigella. The resistance rate of ESBLs-producing strains to first,second and third-generation cephalosporins as well as aztreonam was respectively significantly higher than that of ESBLs non-producing strains, but both of them were high sensitive to imipenem,cefoxitin,ciprofloxacin and gentamicin. Conclusion The positive rate of ESBLs- producing Shigella stains is lower in the district, but the trend of nosocomial infection to community in- fection should be paid more attention to. It is vital to use antibiotics rationally.

关 键 词：志贺菌属β内酰胺酶类 抗药性 细菌 

分 类 号：R446.5[医药卫生—诊断学]