198株肺炎克雷伯菌和491株大肠埃希菌耐药性分析  

The drug-resistance analysis of 198 strains of klebsiella pneumoniae and 491 strains of escherichia coli

作　　者：林平[1] 余素飞[2] 吴钟琪[2] 

机构地区：[1]台州学院医学院微生物教研室,浙江台州318000 [2]台州医院检验科,浙江台州317000

出　　处：《疾病控制杂志》2004年第3期234-236,共3页Chinese Journal of Disease Control and Prevention

摘　　要：目的　探讨肺炎克雷伯菌和大肠埃希菌ESBLs的耐药性情况 ,为产ESBLs细菌的监控和治疗提供依据。方法　采用MicroscanwatRAway 4 0系统全自动细菌鉴定 /药敏分析仪、双纸片协同试验法和K B纸片扩散法进行产ESBLs菌株鉴定及药敏测定。结果　两年中共分离到肺炎克雷伯菌和大肠埃希菌 6 89株 ,产ESBLs菌株 77株 ,总检出率为 11.18% ,其中肺炎克雷伯菌检出率 16 .16 % ,大肠埃希菌检出率 9.16 % ;产ESBLs菌株主要分布在ICU、血液科、烧伤病房 ;两种产ESBLs菌株对阿米卡星、亚胺培南均有高度敏感性 ,对头孢唑啉、头孢拉啶、氨苄西林、哌拉西林、阿莫西林 /棒酸、替卡西林、庆大霉素、妥布霉素和奈啶酸均有极高的耐药性 (耐药率 >80 % ) ,高于不产ESBLs组 ,差别有显著性 (P <0 .0 5 )。结论　肺炎克雷伯菌和大肠埃希菌的产ESBLs菌株在临床分离率较高 ,对多种抗生素具有较高耐药性 ,应加强对ESBLs的检测和预防。Objective To probe into the examination and drug-resistance analysis of extended-spectrum β-lacta-mases (ESBLs) produced by klebsiella pneumoniae and escherichia coli, and thus to give evidence for the control and treatment of ESBLs production. Methods Using Micro scan wat RA way-40 system-automatic bacterium identification/medicine-allergy machine, double paper scraps coordination test and K-B paper scraps spread method were used to identify and medicine-allergenic test the production of ESBLs stains. Results In two years, 689 klebsiella pneumonia and escherichia coli stains were separated and 77 ESBLs stains were produced. The total rate was 11.8%. The rate of the klebsiella pneumonia rate was 16.16%, while the escherichia coli rate was 9.16%. These two kinds of stains were mainly distributed in ICU, hematology department and burn ward. And they had high allergy to Amikacin and Imipenem and high drug-resistance to Cefarotin, Cefradine, Ampicillin, Piperacillin, Amoricillinca, Cethalothin, Gentamycine, Tobramycin and Nalidixic acid (the drug-resistance rate >80%), which were higher than those which could not produce ESBLs. There was significant difference (P<0.05). Conclusions Klebsiella pneumonia and escherichia coli which produce ESBLs stains were highly separated in clinical test. They have high drug-resistance to many antibiotics. We should strengthen the testing and prevention of ESBLs.

关 键 词：肺炎克雷伯菌 大肠埃希菌 耐药性 抗生素 耐药基因 

分 类 号：R378[医药卫生—病原生物学]