产科感染革兰阴性菌株产超β-内酰胺酶检测及耐药性分析

Detection of extended spectrum β-lactamases and analysis of antibiotic resistance in gram-negative bacteria of obstetrics infection

目的了解引起产科感染革兰阴性杆菌产超β-内酰胺酶(ESBLs)及耐药情况。方法采用ESBLs确认试验检测ESBLs,头孢西丁三维试验检测AmpC和K-B进行药敏试验。结果革兰阴性杆菌ESBLs、AmpC酶总检出率分别为32.0%、33.6%,单产ESBLs、单产AmpC、同产ESBLs+高产AmpC酶和ESBLs+诱导AmpC酶菌株依次占11.9%、13.5%、14.1%和6.03%,总分离株对亚胺培南、头孢哌酮-他唑巴坦的耐药率分别为5.28%、6.54%,其次为头孢吡肟,为25.0%。单产酶株较非产酶株,双产酶株较单产酶株具有较高的耐药率。结论产酶是产科感染革兰阴性菌株多重耐药的主要原因之一,亚胺培南和头孢哌酮-他唑巴坦、头孢吡肟(FEP)对其具有良好的抗菌活性。

Objective To understand the resistance and the actuality of derepressed hyperproduction AmpC enzyme and production of extended-spectrum β-lactamases （ESBLs） in obstetrics infection isolates of Gram-negative bacteria. Methods To detect the derepressed hyperproduction AmpC enzyme and production of ESBLs in Gram-negatlve bacteria by the modified three-dimensional extract test and the disk corroborate test strains were identified by susceptibility test. Results In this sample,the producing rate of ESBLs and AmpC were 32% ,33.6%. The constituent rate of Gram-negative, with could produce ESBLs, AmpCs, ESBLs ＋ high product AmpCs, ESBLs ＋high inducible AmpCs were 11. 9%,13.5%,14. 1% and 6.03%.The Gram-negative bacteria was sensitive to IMP and CSL,and their resistance rates to IMP and CSL were 5.28%,6.54%. respectively,the resistance rates to PEP was 25.0% The mutli-drug-resistance rate of the strains producing single ESBLs or single AmpCs and producing both enzymes were higher than that of strains no producing enzymes, and the resistance rate of the strains producing both enzymes were higher than that of strains producing single ESBLs or single AmpCs. Conclusion The bacteria producing enzymes is one of the major factor of multi-drug resistant in obstetrics infection,imipenem, cefoperazone-sulbactam,eefepime ,were the effective antibiotics against the bacteria producing ESBLs＋AmpCs.