超广谱β-内酰胺酶表型检测的最适底物探讨  

The Perfect Substrates for Laborotory Detection of Extended-spectrum β-Lactamases

作　　者：李轶[1] 周绪华[1] 周在咸[1] 

机构地区：[1]河南省人民医院,河南郑州450003

出　　处：《中华医院感染学杂志》2003年第7期620-621,共2页Chinese Journal of Nosocomiology

摘　　要：目的　了解本地区超广谱 β-内酰胺酶 (ESBL s)表型测定情况 ,给基层实验室提供一个经济、准确的 ESBL s检测方案 ,以防止产 ESBL s细菌的区域性流行。方法　按美国临床实验室标准委员会 (NCCL S) M10 0 - S9文件标准 ,采用纸片扩散法进行 ESBL s的初筛和确认试验。结果　初筛试验各底物检出率不同 ,头孢他啶最低(76 .3% ) ,头孢噻肟和氨曲南最高 (97.4 % ) ,确认试验的头孢噻肟组检出率明显高于头孢他啶组 (P<0 .0 5 )。结论　基层实验室在进行 ESBL s的检测时 ,初筛试验可只选择头孢噻肟、氨曲南两种药物 ,确认试验可选择头孢噻肟组进行检测。OBJECTIVE To investigate ESBLs detection of our district to provide an exact and economical test for rudimentary clinical laboratory and to prevent the spread of producing extended spectrum β lactamases strains. METHODS Disk diffusion screening and phenotypic confirmatory tests for ESBLs of the National Committee for Clinical Laboratory Standards (NCCLS) approved standard M100 S9 were taken. RESULTS The detection rate of screening for ESBLs in Enterobacteriaceae is varied depending on different antimicrobial agents being tested. The lowest detection rate (76.3%) for ceftazidime was showed, but the highest (97.4%) was for aztreonam and cefotaxime. In phenotypic confirmatory test, the detection rate for cefotaxime was higher than ceftazidime (P<0.05, respectively). CONCLUSIONS Rudimentary clinical laboratory personnel can screen for ESBLs production in bacteria by using aztreonam and cefotaxime, and perform the phenotypic confirmatory test by using cefotaxime and cefotaxime/clavulanic acid.

关 键 词：超广谱Β-内酰胺酶 大肠埃希菌 克雷伯菌属 

分 类 号：R446.5[医药卫生—诊断学]