大肠埃希菌AmpC酶、超广谱β-内酰胺酶检测及耐药性分析

The detection of the AmpC and extended-spectrum β-lactamases in Escherichia coli and the analysis of the resistance

目的检测大肠埃希菌AmpC酶和超广谱β内酰胺酶(ESBLs),并分析其耐药性,以指导临床合理用药。方法采用改良三维试验法,分别进行AmpC酶和ESBLs测定。结果300株大肠埃希菌AmpC酶、ESBLs检出率分别为3.7%(11/300)、24.7%(74/300),其中同时产AmpC酶和ESBLs菌株检出率为2.3%(7/300)。产酶菌株对17种抗生素(除亚胺培南全部敏感外)的耐药率均高于平均水平。结论大肠埃希菌对β内酰胺类抗生素耐药的主要原因是产生AmpC酶和ESBLs,对产酶菌株临床经验用药可选用碳青霉烯类抗生素。

Objective To detect the AmpC and the extended-spectrum β-lactamases(ESBLs) in Escherichia coli(E.coli) and to analyze the drug susceptibility. Methods AmpC and ESBLs were detected by improved three dimensional test. Results The detection rates of AmpC,ESBLs and AmpC+ESBLs in E.coli were 3.7%(11/300), (24.7%)(74/300) and 2.3%(7/300) respectively. The resistant rate of the E.coli producting AmpC and ESBLs to 17 kinds of antibiotics was higher than the average. Conclusions Producting AmpC and ESBLs is the main mechanism of resistance in E.coli. Carbopenems could be chosen as clinical experiential medication.