阴沟肠杆菌超广谱β-内酰胺酶检测及耐药性分析  

Detection of Extended-Spectrum β-Lactamases and Analysis of Antibiotic Resistance in Clinical Isolates of Enterobacter cloacae

作　　者：杜廷义[1] 周兵[1] 马东亮 刘海云[1] 董云华[1] 曾光雄[1] 

机构地区：[1]云南省临床检验中心,云南昆明650032 [2]云南省陆良县中医院,云南陆良县655600

出　　处：《中华医院感染学杂志》2001年第2期95-97,共3页Chinese Journal of Nosocomiology

摘　　要：目的　监测阴沟肠杆菌医院感染菌株 ESBL s的产生及其对常用抗菌药物的耐药性。方法　采用 5种底物的“双纸片协同试验”检测 ESBL s;体外药敏试验采用 K- B法 ;实验数据处理使用 WHONET- 5软件。结果　在本组样本的 47株阴沟肠杆菌临床分离株中 ,ESBL s的检出率为 38.3% ;未发现亚胺培南耐药株 ,阿米卡星和环丙沙星的耐药率依次为 17.0 %、2 9.8% ;产 ESBL s和不产 ESBL s菌株间的耐药率存在显著差异。结论　 ESBL s是造成本地区阴沟肠杆菌严重耐药的主要原因之一 ;阴沟肠杆菌感染的治疗应首选亚胺培南 ;OBJECTIVE To determine the productive rates of extended spectrum β lactamases (ESBLs) in the clinical isolates of Enterobacter cloacae, and investigate their resistance to 11 kinds of antibiotics. METHODS To detect ESBLs, 47 strains of E. cloacae were determined by the double disk synergy tests which placing disks of ceftazidime, cefotaxime, ceftriaxone, aztreonam, and cefepime at distance of 20 mm (center to center) from disk containing amoxicillin plus clavulanate. Antibiotic susceptibility test was performed by Kirby Bauer disk diffusion method. The WHONET 5 software was used to analyze test results. RESULTS In this sample, the productive rate of ESBLs was 38.3%. ESBLs producing strains had higher resistance rate than that of non ESBLs producing ones. The resistance rates of antibiotics that could be used in empiric therapy to deal with E. cloacae infection were imipenem(0), amikacin(17.0%), ciprofloxacin(29.8%) and cefepime(38.3%). CONCLUSIONS The antibiotic resistance of E. cloacae in our hospital was very serious, and ESBLs were one of the major mechanisms. Imipenem, amikacin and ciproflozacin were recommended in empiric therapy to deal with E.cloacae infections.

关 键 词：阴沟肠杆菌 超广谱Β-内酰胺酶 耐药性 抗菌药物 

分 类 号：R378.2[医药卫生—病原生物学]