产超广谱β-内酰胺酶细菌的检测及耐药性分析  

Detection and drug resistance of extended spectrum β-lactamase-producing bacteria

作　　者：周秀岚[1] 张叶毛[2] 武芳[3] 赵建平[4] 

机构地区：[1]内蒙古医学院附属医院药学部,内蒙古呼和浩特010050 [2]内蒙古医学院附属医院感染科,内蒙古呼和浩特010050 [3]内蒙古医学院附属医院消化科,内蒙古呼和浩特010050 [4]内蒙古自治区医院检验科,内蒙古呼和浩特010017

出　　处：《中华医院感染学杂志》2012年第7期1489-1491,共3页Chinese Journal of Nosocomiology

基　　金：内蒙古自治区科学技术攻关资助项目(20000211)

摘　　要：目的了解产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的检出率与耐药性,指导临床用药。方法细菌鉴定、药物敏感试验(MIC法)和ESBLs的检测均采用法国生物梅里埃公司VITEK-2Compact全自动细菌培养鉴定仪,统计方法采用Whonet 5.3软件。结果大肠埃希菌的标本来源主要为尿液,占59.8%,肺炎克雷伯菌主要为痰液,占73.0%,产酸克雷伯菌主要为痰液,占75.0%;714株病原菌中,产ESBLs细菌检出220株,检出率为30.8%,其中493株大肠埃希菌中产ESBLs 174株,检出率为35.3%,189株肺炎克雷伯菌中产ESBLs 36株,检出率为19.0%,32株产酸克雷伯菌中产ESBLs 10株,检出率为31.2%;产ESBLs大肠埃希菌与肺炎克雷伯菌对亚胺培南耐药率为0,对哌拉西林/他唑巴坦的耐药率<4.2%,除亚胺培南外,产ESBLs菌株对其他抗菌药物的耐药率显著高于非产ESBLs菌株,差异有统计学意义(P<0.05)。结论产ESBLs细菌的检出率和耐药率呈上升趋势,应加强细菌耐药性的监测。OBJECTIVE To explore the detection rate and drug resistance of extended spectrum lactamase （ESBLs） producing Eschertchia coli and Klebsiella pneumoniae so as to guide the clinical treatment. METHODS Bacterial identification, drug susceptibility testing （MIC method） and ESBLs detection were performed with French Merieux VITEK2 Compact automated bacterial culture and identification device, statistical analysis was performed with Whonet 5.3 software. RESULTS E. coli isolates were mainly from urine, accounting for 59.8%, K. pneumoniae isolates were mainly from sputum, accounting for 73. 0%, Acidproducing Klebsiella isolates were mainly from sputum, accounting for 75.0% of 714 strains of pathogens, there were 220 strains of ESBLs producing bacteria isolated with the detection rate of 30. 8%, among which there were 174 strains of ESBLs producing E. coli with the detectior rate of 35, 3%, 189 strains of ESBLsproducing K. pneumoniae with the detection rate of 19.0M, and 32 strains of ESBLsproducing Acidproducing Klebsiella with the detection rate of 31.2% the drug resistance rates of ESBLsproducing E. coli and K. pneumoniae to imipenem was 0, the resistance rates to piperacillin/tazobactam sodium were less than 4.2 % the resistance rates of ESBLsproducing strains were significantly higher than nonESBLsproducing strains to all of the antibiotics except imipenem, the differences were statistically significant antimicrobial drug was significantly higher than nonESBLs producing strains, the difference was statistically significant （P〈O. 05）. CONCLUSION Detection rate of ESBLsproducing bacteria and drug resistance keep an upward tendency and we should strengthen the monitoring of bacterial resistance.

关 键 词：大肠埃希菌 肺炎克雷伯菌 超广谱Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]