临床血液分离大肠埃希菌株耐药性及生物被膜形成分析  

Antibiotics susceptibility and ability of biofilm formation of escherichia coli strains isolated from blood specimens

作　　者：熊杰[1] 杨继勇[2] 邹自英[1] 朱冰[1] 汪璐[1] 曾平[1] 

机构地区：[1]中国人民解放军成都军区总医院检验科,成都610083 [2]中国人民解放军总医院微生物科,北京100853

出　　处：《重庆医学》2012年第35期3699-3701,共3页Chongqing medicine

摘　　要：目的探讨该院血流感染产超广谱酰胺酶(ESBLs)大肠埃希菌(ECO)检出率及其对常用抗菌药物的耐药性及生物被膜形成能力。方法采用法国生物梅里埃公司的Vitek2-Compact全自动微生物分析仪进行鉴定和药物敏感性分析,采用结晶紫半定量方法检测菌株的生物被膜形成能力。结果 92株ECO临床血液分离菌株中,产ESBLs菌株53株(占57.61%),ESBLs阴性菌株39株(占42.39%)。对3类以上抗菌药物耐药ECO 73株(占79.35%),其中,产ESBLs菌株52株,占总菌株数的56.52%,占产ESBLs菌株数的98.11%。耐药率最高的为氨苄西林(94.57%),其次为头孢唑啉(71.74%)和氨苄西林/舒巴坦(67.39%);环丙沙星和左氧氟沙星的耐药率均在60%以上。对于临床常用的氨苄西林/舒巴坦、头孢菌素类、氟喹诺酮类、氨基糖苷类的妥布霉素和单酰胺类抗菌药物,与ESBLs阴性菌株相比,产ESBLs菌株的最小抑菌浓度(MIC)值显著升高,耐药率显著升高(P<0.05)。而对头霉素类、呋喃类、氨基糖苷类的庆大霉素和阿米卡星、含酶抑制剂的哌拉西林/他唑巴坦和碳青霉烯类抗菌药物的敏感性ESBLs阳性组与ESBLs阴性组比较,差异无统计学意义(P>0.05)。96.74%的ECO临床血液分离株具有生物被膜形成能力,生物被膜形成量以中量为主。结论该院ECO血液分离菌株产ESBLs比例高,生物被膜形成能力强,呈现多药耐药的特征。Objective To approach the drug resistance of Escherichia coli isolated from blood producing extendedβ lactamases（ESBLs） and its ability of biofilm formation,and provide guidance for clinical medication and nosocomial infection control.Methods Escherichia coli identification and drug sensitivity was detected using Vitek2 Compact of biomerieux.The method of microtiter plate culture crystal violet stain was used for quantitative analysis of biofilm formation.Results A total of 53（57.61%） Escherichia coli producing ESBLs were isolated from 92 Escherichia coli clinical strains.And which didn′t produce ESBLs were 39（42.39%） strains.Escherichia coli that resistant to more than three kinds of antibiotics was 73 strains（79.35%）,in which 52 producing ESBLs（56.52%）.The most resistant antibiotic was ampicillin（94.57%）,the next was cefazolin（71.74%） and ampicillin/sulbactam（67.39%）.The resistant rate of ciprofloxacin and levofloxacin was over 60%.The MIC of ESBLs strains of antibiotics often used by clinical including ampicillin/sulbactam,cephems,fluoroquinolones,tobramycin and monobactams was increased significantly compared with ESBLs negative strains.The resistant rate of ESBLs strains compared with ESBLs negative strains increased（P0.05）.Cefotetan,nitrofurans,amikacin and gentamicin,piperacillin/tazobactam and carbapenems were susceptible both to ESBLs strains and ESBLs negative strains（P0.05）.96.74% of the 92 Escherichia coli strains had the ability of biofilm forming,and most isolates formed medium or more quantity of biofilm.Conclusion The isolating rate of Escherichia coli from blood producing ESBLs was much higher than most hospital that had reported,and having strong ability to form biofilm and resistant to many different kinds of antibiotics.

关 键 词：血标本 肠产毒性大肠杆菌 Β内酰胺酶类 生物膜 抗药性 

分 类 号：R446.5[医药卫生—诊断学]