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下呼吸道感染患者中产超广谱β-内酰胺酶菌株的药敏分析 被引量:66

Extended-spectrum β-Lactamases Producing Strains in Patients with Lower Respiratory Tract Infection:A Drug Sensitivity Study
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摘要 目的 了解下呼吸道感染患者中肺炎克雷伯菌和大肠埃希菌产超广谱β-内酰胺酶 (ESBL s)及产 ESBL s菌株的药敏情况。方法 收集 2 0 0 0年 10月~ 2 0 0 1年 10月从我院下呼吸道感染患者中分离出的肺炎克雷伯菌和大肠埃希菌 2 40株 ,用表型确认试验检测 ESBL s;用 Kirby- Bauer琼脂扩散法作药敏试验。结果  2 40株肺炎克雷伯菌和大肠埃希菌中 ,共检出产 ESBL s菌 78株 ,检出率为 3 2 .5 0 % ,其中肺炎克雷伯菌为 2 8.5 7% ,大肠埃希菌为 3 4.62 % ;除亚胺培南、头孢哌酮 /舒巴坦、哌拉西林 /他唑巴坦和头孢美唑外 ,产 ESBL s菌对其他 10种抗生素的耐药率均显著高于非产 ESBL s菌 (P<0 .0 1) ;亚胺培南、头孢哌酮 /舒巴坦、哌拉西林 /他唑巴坦和头孢美唑对产 ESBL s菌的耐药率最低。结论 下呼吸道感染患者中肺炎克雷伯菌和大肠埃希菌产 ESBL s情况严重 ;产ESBL s菌对大多数抗生素耐药性比非产 ESBL s菌严重 ,亚胺培南、头孢哌酮 /舒巴坦、哌拉西林 /他唑巴坦和头孢美唑是治疗由产 ESBL OBJECTIVE To investigate extended spectrum β lactamases(ESBLs) production in clinical isolates of Klebsiella pneumoniae and Escherichia coli isolated from patients with lower respiratory tract infection, and the sensitivity of ESBLs producing strains to commonly used antibiotics. METHODS Phenotypic confirmatory test was used to detect ESBLs in 240 strains of K.pneumoniae and E.coli isolated from patients with lower respiratory tract infection; Kirby Bauer agar diffusion method was used to judge drug sensitivity. RESULTS To 32.50% of strains were considered ESBLs producers by phenotypic confirmatory test. The prevalence of ESBLs in isolates of K.pneumoniae and E.coli was 28.57% and 34.62%, respectively. Except imipenem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole, the resistant rates of ESBLs producing strains to other 10 antibiotics were much higher than that of non ESBLs producing strains(P<0.01). The resistant rates of imipinem, cefoperazone/sulbactam, p:peracillin/tazobactam and cefmetazole to ESBLs producing strains were the lowest. CONCLUSIONS The prevalence of ESBLs was high in clinical isolates of K.pneumoniae and E.coli isolated from patients with lower respiratory tract infection. The resistant rates of ESBLs producing strains to most antibiotics were higher than non ESBLs producing strains. Imipenem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole were the effective antibiotics to infections caused by ESBLs producing strains.
出处 《中华医院感染学杂志》 CAS CSCD 2003年第1期78-80,共3页 Chinese Journal of Nosocomiology
关键词 呼吸道感染 产超广谱Β-内酰胺酶菌株 药敏试验 肺炎克雷伯菌 大肠埃希菌 Lower respiratory tract infection Extended spectrum βlactamases Drug resistance Klebsiella pneumoniae Escherichia coli
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