产超广谱β-内酰胺酶菌株检出方法的探讨  

Detection of ESBLs producing Escherichia Coli and Klebsiella pneumoniae isolates

作　　者：许淑珍[1] 刘广华[2] 张淑兰[1] 马纪平[1] 

机构地区：[1]北京首都医科大学附属北京友谊医院检验科,100050 [2]长春市儿童医院检验科

出　　处：《中华检验医学杂志》2000年第5期283-285,共3页Chinese Journal of Laboratory Medicine

基　　金：北京市自然科学基金!资助项目 (7992 0 17)

摘　　要：目的　提高产超广谱β 内酰胺酶 (ESBLs)细菌的检出率。 方法　采用标准纸片扩散法、筛选法、确认法和双纸片协同法进行试验。结果　头孢他啶 (CAZ)、头孢噻肟 (CTX)、氨曲南 (AZT)对产ESBLs大肠埃希菌、肺炎克雷伯菌筛选率分别为 11 2 %、18 5、18 5 %。CAZ/克拉维酸 (clav)对产ESBLs大肠埃希菌、肺炎克雷伯菌确认率分别为 72 3% (34/ 47)、75 0 % (12 / 16 ) ;CTX/Clav对其确认率分别为 78 7% (37/ 47)、93 8% (15 / 16 )。CAZ、CTX与阿莫西林 /克拉维酸 (AMC)纸片边缘间距为 15mm、2 0mm、2 5mm、30mm时 ,出现协同现象率分别为 10 0 %、10 0 % ;83 3%、93 3% ;2 3 3 %、33 3% ;0 0。结论　CTX和AZT对可疑产ESBLs菌株筛选率高于CAZ ;确认试验中CTX优于CAZ ;双纸片协同试验中纸片边缘之间距离为 15mm时协同现象检出率最高。Objective To raise the detection rate of ESBLs producing isolates Methods K B disc diffusion method including disc screening test, disc confirmatory test and double disc synergy test Results The detection rate of suspicious ESBLs producing E coli and K Pneumoniae was 11 2%, 18 5%, 18 5% respectively for ceftazidime (CAZ), cefotaxime (CTX) and aztreonam (AZT) by screening test The detection rate of ESBLs producing E coli and K Pneumoniae was 72 3%, 75 0% and 78 7%, 93 8% for CAZ+CAZ/ clavulanic acid (CAZ/clav ) and CTX+CTX/clav respectively by confirmatory test The rate of synergy phenomenon between CAZ+AMC; and CTX+AMC at different intervals of disk margins (15 mm, 20 mm, 25 mm, 30 mm) were 100%, 100%; 83 3%, 93 3%; 23 3%, 33 3%; and 0.0 respectively Conclusions CTX and AZT are more sensitive than CAZ in screening test The rate of confirmatory test of CTX+CTX/clav disk is higher than that of CAZ+CAZ/clav disk The interval of disk margin 15mm was more sensitive in synergy test

关 键 词：Β-内酰胺酶 抗生素 大肠杆菌 肺炎克雷伯菌 

分 类 号：R446.5[医药卫生—诊断学]