小儿大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶的检测及防治对策

Detection and corresponding measures of prevention and treatment of extend spectrum beta-lactam asea among esherichia coli,klebsiella species in children

目的 探讨小儿大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶(ESLBs)的耐药情况及防治措施。方法 对51例小儿患者细菌培养为大肠埃希菌和肺炎克雷伯菌的药物敏感率,结合临床综合分析。结果 有27例患儿为ESLBs阳性,药物敏感率高低依次为亚胺硫霉素、丁胺卡那霉素、哌拉西林/他唑巴坦(piperacillin/tazobactoam)、环丙氟哌酸、头孢西丁,这五种抗生素药物敏感率依次为96.3%、74.1%、70.4%、63.0%和55.%。其他抗生素敏感率均在25.9%以下。应用头孢曲松钠(菌必治)者细菌产ESLBs明显多于不用菌必治者(P<0.01)。结论 对ESLBs阳性细菌的感染首选亚胺硫霉素。不滥用抗生素,严格做好消毒隔离预防措施。

Objective To explore antibiotic resistance and corresponding measures of prevention and treatment caused by extend spectrum beta-lactam asea(ESBLs) among esherichia coli,klebsiella species in children.Methods 51 patients with esherichia coli and klebsiella species had been analysed.Results 27 ESBLs-producing strain were isolated in the patients.Antibiotic sensentive rates of ESBLs-producing strain to imipenem,amikacin Tazobac/pip/Tazo,ciprofloxacin and cefoxin were 96.3%,74.1%,70.4%,63.0% and 55.6%.Antibiotic sensentive rates of ESBLs-producing strain to other antibiotics were below 25.9%.There was a significant difference in detective rates between using ceftriaxone and not using ceftriaxone,respectively(P<0.01).Conclusions Isolation rate of ESBLs-producing strain from children was high.Imipenem can be used as a first-line drug in the treatment against ESBLs-producing strain disease.Antibiotic can not been misused.The effective measures associated with infection prevention include intensive sterilization and isolation.