不同时期肠杆菌科细菌产ESBLS及耐药性的监测  

Monitoring of ESBLs-producing Enterobacteriaceae and their antibiotic resistance in different periods

作　　者：李永祥[1] 祝建军[1] 宋秀兰[2] 叶金艳 杜玉海[1] 张黎霞 

机构地区：[1]嘉兴市妇幼保健院,浙江嘉兴314000 [2]嘉兴市第一医院,浙江嘉兴314000

出　　处：《中国微生态学杂志》2012年第5期430-431,436,共3页Chinese Journal of Microecology

摘　　要：目的对不同时期肠杆菌科细菌产超广谱β-内酰胺酶(ESBLS)及耐药性进行监测。方法采用生物梅里埃ATB药敏试验板测定肠杆菌科细菌中大肠埃希菌和肺炎克雷伯菌对抗生素的敏感性,同时用表型确证法检测ESBLS。结果肠杆菌科细菌2006-2008年与2009-2011年两个时期相比,ESBLS的检出率增长近50%。对亚胺配南、头孢吡肟、头孢西丁耐药率较低,对哌拉西林/他唑巴坦、阿米卡星的耐药率次之,对其他β-内酰胺类、氨基糖苷类、喹诺酮类及磺胺类抗生素的耐药率较高,且两个时期相比耐药率增加明显,差异具有统计学意义(P<0.05)。结论临床产ESBLS菌株不断增多,多重耐药现象越来越严重,临床实验室应当把ESBLS的检测作为常规监测工作,有效指导临床选用抗菌药物。Objective To monitor Enterobacteriaceae producing Extended-spectrum [3-1actamases （ESBLs） and their antibiotic resistance. Method BioMerieux ATB susceptibility test panels was used to detect the antibiotic resistance of Esche- richia cull and Klebsiella pneumoniae, and ESBLs were detected by using phenotypie confirmatory test. Result The detection rate of ESBLs-producing Enterobacteriaceae increased by nearly 50% from the year period 2006-2008 to 2009-2011. The resistance rates to imipenem, cefepime and cefoxitin were the lowest, followed by piperacillin/tazobactam and amikacin, while the rates to other β-lactams, Aminnglyeosides, Quinolones and Sulfonamides were the highest; The resistance rate in 2009-2011 increased obviously compared with that in 2006-2008, and the difference was significant （P 〈 0.05 ）. Conclusion Clinical ESBLs strains are increasing and their multiple antibiotic resistance are becoming more and more serious. Clinical la- boratories should include ESBLs testing as a part of their routine monitoring to guide the clinical use of antibiotics.

关 键 词：肠杆菌科细菌 超广谱Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]