超广谱 β-内酰胺酶、AmpC酶细菌下呼吸道感染调查、耐药性监测(英文)  

Investigation on ESBLs and Amp C enzymes-producing bacteria from lower respiratory tracts infection and their resistance

作　　者：李艳玲[1] 闫雪[1] 王昆[1] 康健[1] 

机构地区：[1]中国医科大学第一临床学院呼吸疾病研究所,110001

出　　处：《中国现代医学杂志》2004年第7期44-45,49,共3页China Journal of Modern Medicine

摘　　要：目的　了解我院呼吸内科病区下呼吸道标本中产超广谱 β -内酰胺酶 (ESBLs)、AmpC酶细菌检出及耐药情况 ,以指导临床医生合理使用抗生素。方法　收集我院呼吸病房 2 0 0 0年 1月～ 2 0 0 2年 1月期间 ,下呼吸道标本中分离出的肠杆菌科的细菌 ,用纸片扩散法检测细菌的耐药性 ,三维试验的方法检测ESBLs及AmpC酶。结果　共分离 2 0 1株肠杆菌科的细菌 ,产ESBLs细菌 32株 ,占 16 % ,产AmpC酶细菌 19株 ,占9.5 % ,药敏结果显示产ESBLs及AmpC酶细菌对 11种抗菌素的耐药率均高于非产ESBLs及AmpC细菌。结论　呼吸病区下呼吸道标本小肺炎克雷伯杆菌ESBLs检出率最高 ,达 13% ,阴沟肠杆菌AmpC酶的检出率较高。亚胺培南头霉素以及酶抑制剂是对产ESBLs细菌较为有效的药物 ,对产AsmpC酶的细菌 ,亚胺培南、头孢吡肟效果较好 ,对于氨基糖苷、喹诺酮、磺胺类抗菌素多重耐药呈上升趋势。Objective: To investigate isolation and resistance of extended-spectrum β -lactamases (ESBLs) and Amp C enzymes-producing strains in lower respiratory tracts from respiratory department in our hospital and direct clinician to use antibiotics rationally. Methods:Collected Enterobacter isolated from specimens of lower respiratory tracts of patiens in respiratory department in our hospital, from Jan. 2000 to Jan. 2002, and resistance of the bacteria were tested by using standard Kirby-Bauer method. ESBLs and Amp C enzymes were detected by 3-D test method.Results: 201 strains of bacteria were isolated, ESBLs-producing strains were 32 (16.0%)and Amp C enzymes-producing strains were 19 (9.5%), and the resistant rate of these two species are higher than that of no-enzymes-producing ones.Conclusions: Isolation rate of Klebsiella pneumoniae are the highest among the organisms, E. cloacae are the second. Imipenem, cephamycines and β-1actamases inhibitor are effective on ESBLs-producing strains, Amp C enzymes-producing strains are sensitive to imipenem and cefepime, while multiple resistance to aminoglyco-side, quinolone and SD are increased markedly.

关 键 词：超广谱β-内酰胺酶、AmpC酶细菌 下呼吸道感染 调查 耐药性监测 

分 类 号：R563.1[医药卫生—呼吸系统] R977.3[医药卫生—内科学]