肠杆菌科细菌产超广谱β-内酰胺酶检测及耐药性分析  

Detection of extended spectrum β-lactamases and drug resistance in Enterobacteriaceae

作　　者：韩善桥[1] 陆晓白[1] 李杰[1] 马骢[1] 

机构地区：[1]海军总医院检验科,北京100037

出　　处：《中国抗生素杂志》2003年第8期475-476,487,共3页Chinese Journal of Antibiotics

摘　　要：目的　了解我院产超广谱β-内酰胺酶 (ESBL s)肠杆菌科细菌的分离、分布情况及耐药特点 ,以便及时监控和治疗。方法　采用纸片扩散法 ,从 5 33株肠杆菌科细菌筛选出产 ESBL s菌株 ,并对产 ESBL s菌株进行药敏实验。结果　 5 33株肠杆菌科细菌产 ESBL s菌株 96株 (18.0 % ) ,以 ICU病房分离率最高 (2 9.5 % ) ,产 ESBL s细菌对第三代头孢菌素高度耐药 (90 .6 %～ 92 .7% ) ,对环丙沙星、庆大霉素和磺胺甲口恶唑 /甲氧苄啶耐药率也较高 (5 1.0 %～ 88.5 % ) ,对亚胺培南全部敏感。结论　纸片扩散法是一种方便、有效检测 ESBL s的方法 ;治疗产 ESBL s细菌引起的感染 ,可选用亚胺培南、头霉素类及含 β-内酰胺酶抑制剂的复合第三代头孢菌素等敏感的抗生素。Objective To investigate the distribution and drug resistance of Enterobacteriaceae that producing extended-spectrum β-lactamse (ESBLs). Methods A disc diffusion test was used to dectet ESBLs producer. The drug susceptibility test was also conducted. Results 96 (18.0%) of the 533 strains of Enterobacteriaceae isolates were defined to produce ESBLs, the ICU being the highest in all wards. ESBLs-producing strains were highly resistant to the third-generation cephalosporins (90.6%～92.7%), but susceptible to imipenem. Their resistant rates to ciprofloxacin, gentamicin and sulfamethoxazole/trimethoprim were higher than that of non ESBLs producers. Conclusions The disc diffusion test is an effective clinical method for detecting ESBLs. In the detection of bacterial infections caused by ESBLs-producing bacteria, choices should be made to use antibiotics, such as imipenem, cephamycins, β-lactam/β-lactamase inhibitor complex and others which are sensitive to these bacteria.

关 键 词：超广谱β—内酰胺酶 肠杆菌科 细菌 抗药性 

分 类 号：R378.2[医药卫生—病原生物学]