下呼吸道感染大肠埃希菌产ESBLs情况和耐药性监测

Detection of the Production of Extended Spectrum β-lactamases (ESBLs) by Escherichia coli in Lower Respiratory Tract and its Drug Resistance

目的观察下呼吸道感染大肠埃希菌产ESBLs情况及耐药性。方法应用MicroScanAutoSCAN-4专用NC21鉴定板筛选大肠埃希菌产ESBLs,用表型确证试验验证,并研究大肠埃希菌对体外抗生素的耐药性。结果大肠埃希菌对亚胺培南、哌拉西林/三唑巴坦、头孢他啶、阿米卡星的敏感性大于70%;51株大肠埃希菌产ESBLs52.9%,产ESBLs大肠埃希菌对头孢菌素类、青霉素类、氨基糖苷类、复方新诺明等抗生素呈现多重耐药,仅亚胺培南、哌拉西林/三唑巴坦的耐药率在14.8%以下;非ESBLs大肠埃希菌耐药率大于70%的有氨苄西林、哌拉西林。结论本地区下呼吸道感染大肠埃希菌耐药严重,具有较高的产ESBLs流行率,对于产ESBLs大肠埃希菌应以亚胺培南、哌拉西林/三唑巴坦为首选药物。

Objective:To observe the production of Extended Spectrum β-lactamases(ESBLs) by Escherichia coli in Lower respiratory tract and its drug resistance.Methods:ESBLs produced by Escherichia coli NC-was detected with 21 board of MicroScan AutoSCAN 4 and the resistance to antibiotic was also studied in vitro, which were performed for screening and confirming the presence of ESBLs according to the methods published by the NCCLS (national committee for clinical laboratory standards) in 1999.Results:The susceptibility of Escherichia coli to Imipenem, piperacillin/tazobac, cefotadine, amikacin was beyond 70%.The ESBLs-positive rate was 52.9% in 51 strains of Escherichia coli. The drug resistance to cephalosporins, penicillins, am inoglucosides, trimethoprim/sultamethoxazole in Escherichia coli strains that produced ESBLs was of multiple effects, but the rate of the drug resistance to Im ipenem, piperacillin/tazobac was below 14.8%.The drug resistance rate of non-ESBLs-producing strains to ampicillin, piperacillin was beyond 70%.Conclusions:The drug resistance of Escherichia coli in the infection of lower respiratory tract was serious in Qingyuan Region,and there was high prevalence of the ESBLs-production. It was suggested that Im ipenem and piperacillin/tazobac should the first-used-drug to kill the Escherichia coli strains that produce ESBLs.