产酶革兰阴性杆菌致医院感染与耐药特性  

INFECTION AND DRUG-RESISANC OF ZYMOGENIC GRAM-NEGATIVE BACTERIA

作　　者：冷军[1] 孙玉国[1] 

机构地区：[1]济南市第四人民医院检验科,山东济南250031

出　　处：《中国微生态学杂志》2003年第3期159-160,共2页Chinese Journal of Microecology

摘　　要：目的 :了解超广谱 β 内酰胺酶 (ESBLs)与诱导型 β 内酰胺酶革兰阴性杆菌致医院感染的检出率及耐药特点 ,对产酶与不产酶菌株进行耐药性对比分析 ,为临床用药提供依据。方法 :双纸片试验检测ES BLs与诱导酶 ,EtestESBLs试条确定产ESBLs菌株 ,对临床分离的 96 0株细菌采用K B法进行药物敏感试验。结果 :哌拉西林、头孢他啶、亚胺培南、环丙沙星对 2 96株铜绿假单胞菌的抗菌活性较强 ;肺炎克雷伯菌和大肠埃希菌对亚胺培南 10 0 %敏感 ,对氨基糖苷类、氟喹诺酮类、磺胺类药物 ,产ESBLs与不产ESBLs菌株之间呈现交叉耐药。结论 :常规药敏试验不能完全反映产诱导酶的铜绿假单胞菌耐药特点 ,EtestES BLs试条可提高检测ESBLs的阳性率和准确性 ,产ESBLs革兰阴性杆菌的耐药性高于非产酶菌株 ,ESBLs菌引起的感染 ,应用亚胺培南、头霉素类进行治疗。Objective:To implore the detectable rate and drug-resistance of inhospital infection by extended-spectrum beta-lactamases(ESBLs) and induced beta-lacamases gram-negative bacteria,drug-resistance of zymogenous and non-zymoge nous strain was contrasted to provide prooffor clinical administration.Methods:Double-disktest was used to detect ESBLs and indiced enzyme,and Etest(ESBLs paper) to determince ESBLs strain.960 strains recieed drug-sensitive test by Kirby-Bauer test.Results:296 strains of Pseudomonas were resisted strongly to piperacillim ceftazidime imipenem ciprofloxacin;Klebsiella pneumoniae and Escherichia coli has 100 percent of sensitivity to imipenem,ESBLs and non-ESBLs strains have crossed drug-resistance to aminoglycosides quinolones sulfonamides. Conclusions:Routine drug-sensitivity test can not find completely the drug-resistanc of induced zymogenous Pseudemon as aeruginosa,Etest(ESBLs paper)can increase the positive rate and accuarcy of detecting ESBLs. ESBLs gram-negative bacteria has more durg-resistance than non-ESBLs strain.To deal with the ESBLs-prodicing strains,such antibiotics as imipenem,cefoxitin should be used.

关 键 词：革兰阴性杆菌 医院感染 耐药特性 超广谱Β-内酰胺酶 

分 类 号：R378[医药卫生—病原生物学]