广州地区肠杆菌属高产AmpC酶和超广谱β-内酰胺酶调查

Investigation of highly producing AmpC enzyme and extended spectrum β-lactamase of Enterobacter in Guangzhou

目的了解广州地区临床分离的肠杆菌属高产AmpC酶及超广谱β-内酰胺酶(ESBLs)的情况。方法采用头孢西丁和头孢曲松+氯唑西林三维试验。结果612株菌中初筛出381株可疑菌株进行检测,其中高产AmpC酶有88株(14.4%),产超广谱β-内酰胺酶(ESBLs)261株(42.6%),高产AmpC酶合并产ESBLs28株(4.6%);药敏分析亚胺培南对肠杆菌属耐药率最低为1.1%,头孢吡肟对高产AmpC酶菌株敏感性较高。结论应常规检测高产AmpC酶和ESBLs,强调临床合理应用抗菌药物。

Objective To survey highly producing AmpC enzyme and extended spectrum β lactamase of Enterobacter in Guangzhou. Methods Cefoxitin and ceftriaxone+cloxacillin three dimensional tests were performed to detect the 261 strains of Enterobacter spp. Results In 612 strains of Enterobacter spp., 88 strains (14 4%) were highly producing AmpC enzymes; 261 strains (42 6%) were extended spectrum β lactamase and 28 strains (4 6%) of highly producing AmpC enzymes+extended spectrum β lactamase. Resistant rate of imipenem was 1 1%. Highly producing AmpC enzymes of Enterobacter spp. have higher susceptibility to cefepime. Conclusions It is necessary to detect highly producing AmpC enzymes and extended spectrum β lactamase and rational use of antimicrobial agents should be emphasized during clinical therapy.