产ESBLs的大肠埃希菌和肺炎克雷伯菌的耐药性分析  

Analysis of Antibitotic Resistance of ESBLs-product Escherichia Coli and Klebsiella Pneumoniae

作　　者：钟皎[1] 胡锡池[1] 严子禾[1] 赵文艳[1] 

机构地区：[1]无锡市第二人民医院,江苏无锡214002

出　　处：《中国现代应用药学》2011年第4期372-375,共4页Chinese Journal of Modern Applied Pharmacy

摘　　要：目的探讨我院产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌的耐药性变化,为临床合理使用抗菌药物提供参考依据。方法分析我院2008—2009年从临床送检的各类标本中分离得到的大肠埃希菌和肺炎克雷伯菌,采用MIC法进行药敏试验,双纸片确诊试验测定产ESBLs菌株。结果 2008年分离的764株大肠埃希菌中,产ESBLs的有312株,占40.8%;356株肺炎克雷伯菌中,产ESBLs的有133株,占37.4%。2009年分离得到的499株大肠埃希菌中,产ESBLs的有246株,占49.3%;298株肺炎克雷伯菌中,产ESBLs的有107株,占35.9%。产ESBLs菌株的耐药性显著高于非产ESBLs菌株(P<0.05)。2009年产ESBLs的大肠埃希菌和肺炎克雷伯菌对氨曲南、头孢菌素类三代、四代药物的耐药率明显高于2008年(P<0.05),对喹诺酮类药物的耐药率低于2008年(P<0.05)。2009年产ESBLs肺炎克雷伯菌对亚胺培南的耐药率较2008年上升了15.9%(P<0.05)。结论产ESBLs的大肠埃希菌和肺炎克雷伯菌呈多重耐药现象,必须加强耐药监测,防止产ESBLs菌株的增长、扩散与流行。OBJECTIVE To investigate the trend of antibiotic resistance of extend-spectrum β-lactamases（ESBLs） producing Escherichia coli and Klebsiella pneumoniae in our hospital,and to provide a guidance for clinical rational use of antibiotics.METHODS Escherichia coli and Klebsiella pneumoniae strains were collected,which were isolated from patients in clinical in 2008-2009.Bacterial susceptibility testing were detected by MIC methods and ESBLs-producing strains were detected by double-disc diffusion confirming test.RESULTS In 2008,312 of 764 strains of Escherichia coli were considered ESBLs,the rate of ESBLs were 40.8%;133 of 356 strains of Klebsiella pneumoniae were considered ESBLs,the rate of ESBLs were 37.4%.In 2009,246 of 499 strains of Escherichia coli were considered ESBLs,the rate of ESBLs were 49.3%;107 of 298 strains of Klebsiella pneumoniae were considered ESBLs,the rate of ESBLs were 35.9%.The resistance rate of ESBLs-producing strains were significantly higher than that of ESBLs non-producing strains（P0.05）.The resistance rate of ESBLs-producing strains to aztreonam and cephalosporin were higher in 2009 than in 2008（P0.05）.The resistance rate of ESBLs-producing strains to quinolones were lower in 2009 than in 2008（P0.05）.The resistance rate of ESBLs-producing strains of Klebsiella pneumoniae to imipenem was increased by 15.9% in 2009（P0.05）.CONCLUSION ESBLs producing Escherichia coli and Klebsiella pneumoniae have the multidrug-resistant phenomenon,surveillance should be intensified,so as to avoid the increasing,diffusive and popular of ESBLs-producing bacteria.

关 键 词：产超广谱Β-内酰胺酶 大肠埃希菌 肺炎克雷伯菌 抗菌药物 

分 类 号：R969.3[医药卫生—药理学]