阴沟肠杆菌临床感染分布特征及耐药性分析  

Analysis the distribution and the drug resistance of clinical infection due to Enterobacter cloacae

作　　者：曹弟勇[1] 徐彬[1] 陈大斌[1] 

机构地区：[1]川北医学院药物研究所,四川南充637000

出　　处：《国际检验医学杂志》2010年第9期915-917,共3页International Journal of Laboratory Medicine

基　　金：四川省教育厅青年基金(08zb072)

摘　　要：目的 了解川北地区阴沟肠杆菌的临床分布特征及耐药情况.方法 回顾性分析临床分离59株阴沟肠杆菌的临床感染分布情况,琼脂稀释法进行药敏试验,改良三维试验检测产超广谱β-内酰胺酶（ESBLs）和产AmpCβ-内酰胺酶（AmpC）,敏感、中介、耐药的判定采用美国临床实验室标准化协会（CLSI）2006年公布的标准.结果 59株阴沟肠杆菌在痰液和尿液标本、重症监护病房和呼吸科检出率高,且全部菌株除对亚胺培南耐药率极低外（3.39%）,对其他11种抗菌药物的耐药率均大于20%;59株细菌中,检出产ESBLs和AmpC共计34株,单产ESBLs、同时产AmpC和ESBLs、单产AmpC菌株检出率分别为30.5%、8.47%、18.65%,ESBLs阳性菌株的检出率为38.97%,且ESBLs阳性菌株对除亚胺培南之外的其他11种抗菌药物显示了极高耐药率（44.45%～100%）.结论 川北地区阴沟肠杆菌以引起危重患者的呼吸道和泌尿道感染为主,阴沟肠杆菌具有较高的ESBLs检出率,且多重耐药严重.Objective To investigate the clinical distribution and the drug resistance of Enterobacter cloacae in North Sichuan Area. Methods Retrospective study the clinical distribution of isolated 59 Enterobacter cloacae. Agar dilution medthod was used for drug sensitivity test, the phenotypes of Enterobacter cloacae strains harboring AmpC β-lactamases（AmpC）and extended spectrum β-lactamases（ESBLs） were detected by modified three-dimensional extract test. The results of sensitive, intermediary, tolerance were evaluated according to the Clinical Laborarory Standarads Institute（CSLI）of released in 2006. Results 59 Enterobacter cloacae were especially common the specimens in sputum, urine, intensive care unit（ICU）and respiratory medicine. But for showing the lowest resistant rate to imipenem（3.39%）,the resistant rates to the other 11 types antibacterial agents were more than 20%. ESBLs and AmpC were carryed on a total of 34 strains of Enterobacter cloacae. AmpC β-1actamases, AmpC β lactamases combined with ESBLs and ESBI.s producing strains were detected in 30.5 % ,8.470% and 18.65 β of Enterobacter cloacae respectively, the relevance ratio of ESBLs positive strains was 38. 98%. The great height resistant rate to 11 types antibacterial agents except imipenem were showed in ESBLs positive strains（44.45%-100%）. Conclusion Enterobacter cloacae often induces respiratory tract infection and urinary tract infection and the relevance ratio of ESBLs was very high and the multiple drug resistance was very serious in North Sichuan Area.

关 键 词：肠杆菌 阴沟 抗药性 细菌 微生物敏感性试验 

分 类 号：R446.5[医药卫生—诊断学]