产超广谱β-内酰胺酶肺炎克雷伯菌和大肠埃希菌药敏分析  

Drug sensitivity analysis of extended spectrum β lactamases-producing Klebsiella pneumoniae and Escherichia coli

作　　者：马丽萍[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院西区检验科,湖北武汉430056

出　　处：《检验医学与临床》2011年第5期526-527,共2页Laboratory Medicine and Clinic

摘　　要：目的了解产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌的分离率及其耐药情况,为临床治疗提供依据。方法收集2007年1月至2009年12月临床送检患者标本分离出的肺炎克雷伯菌和大肠埃希菌,采用常规生化方法和梅里埃API20E系统鉴定、纸片扩散确证试验检测ESBLs,药敏试验采用纸片扩散法。结果 281株大肠埃希菌和174株肺炎克雷伯菌确证试验产ESBLs阳性率分别为36.2%和40.9%,产ESBLs菌对β-内酰胺类抗菌药高度耐药,对阿米卡星、头孢西丁、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿莫西林/克拉维酸、替卡西林/克拉维酸耐药性在5.4%～25.6%,对环丙沙星、复方新诺明和庆大霉素耐药率较高,为65.1%～88.9%,未发现耐亚胺培南产超广谱β-内酰胺酶肺炎克雷伯菌和大肠埃希菌。结论产ESBLs菌的问题日益严重,临床及时了解它们的耐药特点和变化趋势,对合理应用抗菌药物、延缓细菌耐药性的产生,控制播散菌株的流行具有十分重要的意义。Objective To investigate the antimicrobial resistance and the isolating rate of extended spectrum β lactamases（ESBLs）-producing Klebsiella pneumoniae and Escherichia coli to rationalize clinical medication.Methods To collect the samples of isolated Klebsiella pneumoniae and Escherichia coli from January 2007 to December 2009 and to identify with common biochemistry and Marcel API20E system.To detect ESBLs by disk diffusion confirmation test.The drug sensitivity test was performed by disk diffusion method.Results 281 strains of Escherichia coli and 174 strains of Klebsiella pneumoniae were verified to produce ESBLs,the positive rates were 36.2% for Escherichia coli and 40.9% for Klebsiella pneumoniae respectively.ESBLs-producing bacteria were highly resistant to antibiotics with β lactamases,5.4%~25.6% to amikacin,cefoxitin,cefoperazone-sulbactam,piperacillin-tazobactam,amoxicillin-clavulanic acid,ticarcillin-clavulanic acid,and 65.1%~88.9% to ciprofloxacin,centamicin and SMZ-TMP.There were no ESBLs-producing strains of Escherichia coli and Klebsiella pneumoniae with resistance to imipenem.Conclusion The problem of ESBLs-producing bacteria is getting more serious.Clinical physicians ought to understand the drug-resistance characteristics and the change trend of ESBLs-producing Escherichia coli and Klebsiella pneumoniae,which is important to use antibiotics rationally,delay the production of bacterial drug-resistance and control the spread of drug-resistant strains.

关 键 词：产超广谱内β酰胺酶 大肠埃希菌 肺炎克雷伯菌 抗药性 细菌 

分 类 号：R978.11[医药卫生—药品]