超广谱β—内酰胺酶的分布及耐药结果分析  

Analysis of Distribution and Resistance of Extended Spectrum β-Lactamase

作　　者：褚云卓[1] 年华[1] 贾桂英[1] 刘桂荣[1] 王倩[1] 郭红 

机构地区：[1]中国医科大学第一临床学院检验科,沈阳110001 [2]辽宁省职业病院

出　　处：《中国公共卫生》2001年第11期1024-1025,共2页Chinese Journal of Public Health

摘　　要：目的　了解产超广谱 β -内酰胺酶 (ESBLs)的肺炎克雷伯菌和大肠埃希菌的耐药特点 ,防止产ESBLs菌株的暴发流行。方法　对符合美国临床实验室标准化委员会 (NCCLS)过筛标准的肺炎克雷伯菌和大肠埃希菌用双纸片协同试验法进行确证。结果　 2 6 4株肺炎克雷伯菌 (82株 )和大肠埃希菌(182株 )中有 2 9株产ESBLs,阳性率为 11 0 % ,其中肺炎克雷伯菌产ESBLs的阳性率为 15 9% (13/ 82 ) ,与文献报道的 14%～ 16 %相一致 ,而大肠埃希菌产ESBLs的阳性率为 8 8% (16 /182 ) ,产ESBLs的菌株对氨基糖苷类、氟喹诺酮类、磺胺类、四环素类抗生素都有不同程度的耐药 ,且耐药率明显高于不产ESBLs菌株。产ESBLs菌在医院内分布较广泛 ,有 12个病房及门诊分离到产ESBLs菌株 ,而且在不同标本中都分离到产ESBLs菌株。因此合理应用抗生素 ,尤其是外科手术预防用药应从一线药用起 ,对防止ESBLs的产生有重要意义。结论　产ESBLs的细菌为多重耐药菌 ,耐药质粒可在细菌间传播 。Objective To understand the characteristics of the resi/stance of Klebsiella pneumoniae and Escherichia coli producing extended spectrum β-lactamase(ESBLs) and to prevent a nosocomial outbreak of organisms producing ESBLs.Methods Using double-disk cooperative test to corroborate K.Pneumoniae and E.Coli measuring up to the screen standard established by National Committee for Clinical Laboratory Standards (NCCLS).Results Twenty nine strains of all 264 isolates(82 strains of K.Pneumoniae and 182 strains of E.Coli) produced ESBLs,and the positive rate was 11.0%.Among them,the positive rate of K.Pneumoniae was 15.9%(13/82) and that of E.Coli was 8.8%(16/182).Strains producing ESBLs not only had different degree resistance to aminoglycosides,quinolones,sulfa and tetracycline,but also the resistant rate of strains producing ESBLs was obviously higher than that of non-producing ESBLs strains.There was widespread nosocomial dissemination of organisms producing ESBLs which were isolated in various specimen from clinic and 12 wards.Conclusion Bacteria producing ESBLs was multiple resistant organisms and drug resistant plasmid could spread among bacteria causing regional outbreak and prevalence.

关 键 词：超广谱Β-内酰胺酶 肺炎克雷伯氏菌 大肠埃希菌 产ESBLS菌株 耐药性 抗生素 

分 类 号：R978.1[医药卫生—药品]