肠杆菌科超广谱β-内酰胺酶检测及其临床应用  

The measurement of extended spectrum β lactamase in Enterobacteriaceae and its preliminary clinical application

作　　者：李金钟 段雄波 相青珍 李兰平 

机构地区：[1]河北省新乐市医院,新乐050700

出　　处：《中国抗生素杂志》1999年第5期347-349,共3页Chinese Journal of Antibiotics

摘　　要：应用琼脂稀释法、Ｅｔｅｓｔ法分别测定了１６３株肠杆菌科细菌对１２种β－内酰酶胺类抗生素的最低抑菌浓度（ＭＩＣ）和超广谱β－内酰胺酶（ＥＳＢＬ），同时对含ＥＳＢＬ与不含ＥＳＢＬ菌株的药敏结果加以分析。结果：４．５％ 大肠埃希氏菌、１９．４％ 克雷伯氏菌、２３．１％ 沙雷氏菌、１０％ 弗氏柠檬酸杆菌和３３．３％ 阴沟肠杆菌ＥＳＢＬ阳性，总检出率为１１％ 。含ＥＳＢＬ菌株对１２ 种β－内酰胺类抗生素中的９ 种呈多重耐药，其耐药率３３．３％ ～１００％ ；而多数不含ＥＳＢＬ菌株仅对氨苄西林、羧苄西林和头孢唑林耐药，其耐药率５５．２％ ～８７．５％ 。应严格区分菌株是否含ＥＳＢＬ，并对含ＥＳＢＬ菌株的耐药性给予广泛关注。The minimal inhibitory concentration (MIC) of β lactam antibiotics and extended spectrum β lactamase (ESBL) were tested against 163 strains of Enterobacteriaceae from infectious samples by the agar dilution method and Etest method, respectively. And assays the susecptible results between ESBL positive strains and ESBL negative strains. The rsults showed: 4.5% of E.coli ; 19.4% of Klebsiella sp.; 23.1% of Serratia sp.; 10% of C.freundii and 33.3% of E.cloacae wer found ESBL positive respectively, the total detection rate was 11%. The ESBL positive strains showed multiresistance to 9 of 12 β lactam antibiotics with rates ranging from 33.3%~100% and most of ESBL negative strains were only resistant to ampicillin, carbenicillin and cefazolin with rates ranging from 55.2%~87.5%. It is necessary to distinguish ESBL strain and non ESBL strain strictly. Dealing with ESBL strains should be emphasized.

关 键 词：超广谱 Β-内酰胺酶 最低抑菌浓度 肠杆菌科 

分 类 号：R978.11[医药卫生—药品]