大肠埃希菌ESBLs、AmpC酶的检测及耐药特性  

Detection of ESBLs or AmpC β -lactamase in Escherichia coli and drug resistance

作　　者：柏彩英[1] 黄瑞玉[1] 周才[1] 邓文喻[1] 赖卫明[1] 周强[2] 

机构地区：[1]广东省妇幼保健院检验科,广州510010 [2]广东省中医院检验科,广州510120

出　　处：《国际医药卫生导报》2013年第13期1893-1895,共3页International Medicine and Health Guidance News

基　　金：广东省社会发展攻关课题（2009B030801284）

摘　　要：目的 分析大肠埃希菌产超广谱β-内酰胺酶（ESBLs）、头孢菌素（AmpC）酶的情况及耐药特性,指导临床合理用药.方法 收集2011年1月至2012年6月我院临床分离的大肠埃希菌287株.用双纸片确诊法检测ESBLs,三维试验检测AmpC酶,KB法进行药敏试验.结果 287株大肠埃希菌中,产ESBLs 119株（41.5％）,产AmpC酶47株（16.4％）,同时检出产ESBLs和AmpC酶16株（5.6％）.单一产ESBLs或AmpC酶的菌株有较高的耐药性,同时检出ESBLs和AmpC酶的菌株对多种抗菌药耐药,所有菌株对亚胺培南均敏感.结论 大肠埃希菌ESBLs和AmpC酶的分离率及耐药率都较高,同时检出ESBLs和AmpC酶的菌株具多重耐药性；亚胺培南具有良好的抗菌活性.临床应加强ESBLs和AmpC酶的检测及耐药监测,采取有效措施防止耐药菌株产生.Objective To investigate extended-spectrum β-lactamases （ESBLs）,AmpC β-lactamase and drug resistance in Escherichia coli （E.coli） for instructing rational medication uses.Methods 287 E.coli strains were isolated in our hospital from January 2011 to June 2012.ESBLs were detected by the double-disk method; AmpC were detected by the three dimensional extract test; and the drug sensitivity was tested by the KB method.Results Of the 287 E.coli strains,119 （41.5%） strains produced ESBLs and 47 （16.4%） strains produced AmpC,and ESBLs and AmpC were simultaneously detectable in 16 strains （accounting for 5.6%）.ESBLs-or AmpC-producing strains had a higher drug resistance; ESBLs-and AmpC-producing strains had multiple drug resistance.All the strains had susceptibility to imipenem.Conclusions The rates of isolation and drug resistance are higher for ESBLs-or AmpC-producing E.coli; ESBLs-and AmpC-producing strains have multiple drug resistance.Imipenem has good antibacterial activity.Detection of ESBLs and AmpC and monitoring of drug resistance should be strengthened clinically and effective measures must be taken to prevent resistant strains.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 AMPC酶 耐药性 

分 类 号：R446.5[医药卫生—诊断学]