产超广谱β-内酰胺酶细菌感染临床流行病学  

Clinical epidemiological study on bacteria producing extended-spectrum β-lactamases

作　　者：孙秋林[1] 叶冬青[2] 李旭[1] 

机构地区：[1]安徽医科大学附属医院传染科,安徽合肥230022 [2]安徽医科大学公共卫生学院

出　　处：《中国微生态学杂志》2004年第2期104-105,共2页Chinese Journal of Microecology

摘　　要：目的 :了解产超广谱β 内酰胺酶 (ESBLs)肺炎克雷伯菌 (Kpn)和大肠埃希菌 (Eco)感染的影响因素。方法 :根据我院实验室登记的各种标本中细菌培养的阳性报告 ,回顾调查了 1999年 2月～ 2 0 0 0年 12月在我院住院的 2 0 1份病历。结果 :2 0 1份病例送检的标本中 ,检出产ESBLs细菌 76株 ,检出率 37 8%(其中Kpn 2 5株 ,Eco 5 1株 )。非产ESBLs细菌为 12 5株 (其中Kpn 2 4株 ,Eco 10 1株 )。多因素分析结果表明侵袭性操作、第三代头孢菌素及其他 β 内酰胺类药物的应用、医院感染为产生ESBLs肺炎克雷伯菌和大肠埃希菌感染的危险因素 (OR值分别为 2 314、3 4 33、2 2 76、2 6 6 5 ) ;而基础疾病、免疫抑制剂、喹诺酮类药物的应用 ,与产ESBLs肺炎克雷伯菌和大肠埃希菌感染无统计学意义 (P >0 0 5 )。结论 :影响产ES BLs菌感染的临床危险因素为第三代头孢菌素及其他β 内酰胺类药物的应用、医院感染、侵袭性操作。Objective:To study influence factors on infections caused by Klebsiella pneumoniae and Escherichia coli producing extended-spectrum β-lactamases.Methods:In accordance with our clinical laboratory reports of Klebsiella pneumoniae and Escherichia coli isolated from various specimens,the retrospective study was conducted to investigate the risk factors of ESBLs-producing K.pneumoniae and E.coli infection in 201 patients admitted to our hospital through multivariable analyses February,1999 to December,2000.Results:In 201 cases,76 bacteria of ESBLs-producing K.pneumoniae and E.coli were isolated.The total incidence of ESBLs in K.pneumoniae and E.coli accounted for 37.8 percent.(25 K.pneumoniae producers,51 E.coli producers).Non-ESBLs-producing straints were 125(K.pneumoniae and E.coli were 24 and 101 respectively).Multiple variable analyses results showed that Odds ratio (OR) was significantly higher in invasive manipulation,using β-lactamas antibiotics and the third-generation cephalosporins,nosocomial infections than the nonexposure.They were 2.314,2.276,3.433 and 2.665 respectively.Nevertheless basic diseases,using immunosuppressive drugs and using Quinolone did not effect significantly on ESBLs bacteria infection(P>0.05).Conclusion:Prior receipt of β-lactams antibiotics,especially the third-generation cephalosporins,invasive manipulation and nosocomial infections were significantly associated with ESBLs-producing K.pneumoniae and E.coli.

关 键 词：超广谱Β-内酰胺酶 细菌感染 肺炎克雷伯菌 大肠埃希菌 Β-内酰胺类药物 流行病学 

分 类 号：R378[医药卫生—病原生物学]