多重耐药大肠埃希菌产β-内酰胺酶及耐药表型分析  

Analysis of antimicrobial resistance and β-lactam-producing in multiply antimicrobial-resistant Escherichia coli

作　　者：欧阳育琪[1] 林应标[1] 黄红卫[1] 黄强[1] 熊劲芝[1] 

机构地区：[1]湖南省郴州市第一人民医院感染控制科,423000

出　　处：《检验医学与临床》2010年第13期1283-1285,共3页Laboratory Medicine and Clinic

基　　金：湖南省郴州市第一人民医院科研基金资助项目(N2008-091)

摘　　要：目的分析多重耐药大肠埃希菌产β-内酰胺酶与β-内酰胺类抗生素耐药表型的关系,为临床合理使用抗生素提供实验依据。方法用碘淀粉测定法、三维试验、协同法、纸片扩散(K-B)确证试验分别检测青霉素酶、头孢菌素酶、金属β-内酰胺酶和超广谱β-内酰胺酶(ESBLs);并用K-B法进行药敏试验。结果分离的125株多重耐药大肠埃希菌对头孢类抗生素如头孢噻吩、头孢呋辛、头孢噻肟、头孢他啶、头孢吡肟和头孢西丁的耐药率分别为84.8%、72.0%、56.0%、71.2%、60.8%和28.0%,对氨苄西林/舒巴坦、哌拉西林/他唑巴坦耐药率较低,分别为12.8%和15.2%,对氨苄西林、哌拉西林、替卡西林的耐药率较高,分别为94.4%、90.4%和91.2%,对亚胺培南和美洛培南耐药率仅3.2%。检出产ESBLs细菌63株,检出率50.4%。产ESBLs大肠埃希菌对多种抗生素耐药率明显高于非产ESBLs菌株。结论多重耐药大肠埃希菌、4种产酶类菌株对除亚胺培南和美洛培南以外的其他抗生素均已高度耐药;头孢菌素类耐药率较高,除非药敏试验结果支持,一般不宜作为一线用药。Objective To investigate the relationship between β-lactam-producing multiply Escherichia coli and β-lactam antibiotics resistance to provide reference for using antimicrobial agent reasonablely.Methods Amylometric method,three dimensional test and slip diffusion test were proceeded for detecting penicillinase,metallo-β-lactam antibiotics and superspectrum β-lactam antibiotics respectively,and the antimicrobial susceptibility was determinded by K-B method.Results 125 multiply antimicrobial-resistant Escherichia coli strains were isolated,whose resistant rate to cefalotin,cefuroxime,cefotaxime,ceftazidime,cefepime and cefoxitin was 84.8%,72.0%,56.0%,71.2%,60.8% and 28.0% respectively,which also showed low resistant to sulbactam（12.8%） and tazobactam（15.2%）,but high resistant to ampicillin（94.4%）,piperacillin（90.4%） and ticarcillin（91.2%）.63 （50.4%） ESBLs-producing Escherichia coli strains were isolated,and the resistant rate to polyantibiotic of ESBLs-producing Escherichia coli was higher than that of non-ESBLs-producing Escherichia coli.Conclusion Multiply antimicrobial-resistant Escherichia coli and four erzymes-producing bacteria were resistant to most antibiotics except imipenem and meropenem.The resistant rate of cephalosporins was high,suggesting that cephalosporins are inappsopriate as first line drug except the support from drug sensitive experimental result.

关 键 词：多药抗药性 大肠埃希菌 Β内酰胺酶类 耐药表型 抗药性 细菌 

分 类 号：R378.21[医药卫生—病原生物学] R969.4[医药卫生—基础医学]