大肠埃希菌耐药超广谱β-内酰胺酶检测探讨  

To study the methods of diction E. coli extended spectrum β-lactamases(ESBLs) producing

作　　者：王淑峰[1] 李浩[1] 戎建荣[2] 李连青[2] 

机构地区：[1]山西医科大学第一医院,030001 [2]山西省临床检验中心

出　　处：《山西医药杂志（上半月）》2010年第2期99-101,共3页Shanxi Medical Journal

基　　金：山西省医学留学人员重点基金(20000940)

摘　　要：目的探讨临床微生物实验室及时准确检测大肠埃希菌耐药超广谱β-内酰胺酶(ESBLs)的方法,出具更加准确的实验报告,为临床合理使用抗生素提供科学依据。方法①采用头孢噻肟、头孢他啶、头孢吡肟和氨曲南纸片扩散法对分离菌株进行ESBLs初筛试验。②采用头孢噻肟、头孢噻肟加棒酸复合药敏纸片法和头孢他啶、头孢他啶加棒酸复合药敏纸片法对实验菌株进行ESBLs确证试验。结果采用头孢噻肟、头孢噻肟加棒酸复合药敏纸片法和头孢他啶、头孢他啶加棒酸复合药敏纸片法对实验菌株进行ESBLs确证试验时,只采用一组纸片试验会导致结果出现假阴性。结论确证革兰阴性杆菌ESBLs时2组药敏纸片必须同时使用。Objective To study antibiotic resistance phnotypes of E. coli extended spectrum β-lactamases （ESBLs） producing from the Taiyuan area. Methods To screening for ESBLs production by E. coli with Ceftriaxone, cefotaime,ceftazidime,cefpodoxime and azteonam. If any of the zone diameters indicate suspicion for ESBls production, phenotypic confirmatory tests should be used to verify the diagnosis. The cefotacime/clavulanate and ceftazidime/clavulanate combination disks with or without clavulanate are used phenotypic confirmation for the presence of ESBLs in E. coll. Results The sensitivity of the phenotypic confirmatory tests for ESBI.s production will be reduced when detect the ESBLs use either cefotacime/elavulanate or ceftazidime/clavulanate. Conclusion ESBLs are becoming increasingly expressed by many E. coli with a potential for dissemination. They compromise the activity of wide-spcturm antibiotics creating major therapeutic difficulties with a significant on the outcome of patients. The continued emergence of ESBLs presents diagnostic challenges to the clinical microbiology laboratories, who need to be moreaware of the need for their detection. ESBIs occurrence and spread need to be controlled.

关 键 词：抗生素 ESBLS 药敏试验 耐药 

分 类 号：R446.5[医药卫生—诊断学]