安徽淮北地区肠杆菌科细菌耐药性检测

Study on enterobacter resistance to antibiotics in Huaibei area

目的了解本地区肠杆菌科细菌的耐药现状,为临床医生合理使用抗生素提供依据。方法收集本地区三家医院所分离的326株肠杆菌,分析其菌种分布、耐药性。细菌分离、培养按常规方法,菌种鉴定采用MicroScan WalkAWay-40、Vitek-32全自动微生物分析仪,药敏试验采用微量液体稀释法,超广谱β-内酰胺酶(ESBLs)检测采用1999年NCCLS推荐的纸片确证试验。结果在326株肠杆菌科细菌中,分离出大肠埃希菌216株,肺炎克雷伯菌37菌,臭鼻克雷伯菌18株,聚团多源菌19株,产气肠杆菌18株,阴沟肠杆菌18株。ESBLs检出率:大肠埃希菌42.1%、克雷伯菌56.7%;大肠埃希菌、肺炎克雷伯菌等对亚胺培南的耐药率最低,分别为1.4%和2.8%;其次为哌拉西林/他唑巴坦和头孢哌酮/舒巴坦。另外,对庆大霉素和丁胺卡那耐药率也较低。结论淮北地区革兰阴性杆菌菌种分布以大肠埃希菌占首位。亚胺培南是治疗革兰阴性杆菌最有效的药物之一,对于产ESBLs的菌株,头孢哌酮/舒巴坦、哌拉西林/他唑巴坦可以作为优先选用的药物。

Objective To study enterobacter resistance to antibiotics in Huaibei area. Methods Bacteria were cultured by routine method,identified by MicroScan WalkAWay-40 and Vitek-32, antibi- otic susceptibility of bacteria was determined by microdilution. Extended spectrum beta lactamases（ ESBLs） were confirmed by disc with CAZ ＋ CD02 and CTX ＋ CD03. Results The ratios of Esche- richia coli and Klebsiella were higher than others. The rates of ESBLs among Escherichia coli and Klebsiella were 42.1% and 56.7%. Susceptibility of imipenem was higher than the others of antibiotics. Conclusion The ratio of Escherichia coli is the highest among all gram negative rods. Imipenem is the first choice antibiotic in treating infectious diseases caused by gram negative rods carrying ESBLs. In addition,cefoperazone/sulbactam, piperacillin/ tazobactam are secondary choice.