NICU感染ESBLs大肠埃希菌与肺炎克雷伯菌的耐药性分析  

Drug Resistance Analaysis of Extended-spectrum β-Lactamases Producing Escherichia coli and Klebsiella Pneumoniae in NICU

作　　者：彭吉军[1] 蒋华[1] 周旭[2] 

机构地区：[1]怀化市第一人民医院感染管理科,湖南怀化418000 [2]怀化市第一人民医院感染检验科,湖南怀化418000

出　　处：《中国医药指南》2013年第19期446-447,共2页Guide of China Medicine

摘　　要：目的了解NICU感染产超广谱β-内酰胺酶(ESBLs)大肠埃希菌与肺炎克雷伯菌耐药发生情况,以更好的选择抗菌药物提供依据。方法细菌鉴定和药敏试验用ATB Expression细菌鉴定仪及其配套试剂进行自动分析。结果 2010～2012年全院共培养和分离出大肠埃希菌3043株与肺炎克雷伯菌2226株。NICU大肠埃希菌374株(12.29%)中产ESBLs145株(38.77%)和肺炎克雷伯菌799株(34.41%)产ESBLs 384株(48.06%)。产ESBLs菌对青霉素类、头孢菌素和氨曲南均产生耐药,第四代头孢头孢吡肟耐药率也达60%以上,对亚胺培南或美洛培南、丁胺卡那耐药低,其次为派拉西林/他唑巴坦和头孢西丁。而头孢西丁在产ESBLs肺炎克雷伯菌耐药率已上升至50%。结论新生儿为一特殊群体在临床用药相对较为狭窄,在实验室开展ESBLs的检测,对指导临床合理使用抗菌药物、延缓细菌耐药性的产生、有效控制产ESBLs菌的院内播散具有十分重要的意义。Objeetve To investigate the drug resistance of extended-spectrum β-lactamases（ESBLs） producing Escherichia eoli and Klebsiella pneumoniae in NICU,Provding edidenee for the clinical rational administration of antimicrobial drugs. Methods The identification of bacteria and antibiotic susceptibility were performed by Mieroscan ATB Exprssion Analyzer. Results Among 374 isolates of Escherichia coli in NICU, 145 strains（38.77%）were isolated producing ESBLs.A＇rnong 799 isolates of Klebsiella pneumoniae,384 strains（48.06%） were isolated producing ESBLs.ESBLs-produeing bacteria showed high resistance to a greate number of antimicrobial drugs,and relatively low resistance to imipenem,amikacin,piperacillin/tazobactam, and cefoxitin.but the Klebsiella pneumoniae 50% resistances to cefoxitin were showed in NICU. Conclusions Detection of ESBLs prodution and susceptibility to antibiotics in time can provide guidance to rational clinical administions of drugs and also prevent the emergence of the drug resistant strains.

关 键 词：新生儿 产超广谱Β-内酰胺酶 耐药率 

分 类 号：R446.2[医药卫生—诊断学]