超广谱β-内酰胺酶细菌检测及耐药性分析

Detection and Drug-resistance Analysis of ESBLs-producing Bacteria

目的了解本地区2002年2月-2003年2月间产超广谱哥内酰胺酶的菌群分布及耐药性。方法细菌鉴定采用美国Microscan微生物分析仪鉴定菌种和药敏试验，按NCCLS1999推荐方法解释结果。结果检出产ESBLs细菌67株，检出率35．64％，其中肺炎克雷伯菌31株，检出率36．05％，大肠埃希菌29株，检出率43．28％，阴沟肠杆菌6株，检出率22．22％，产酸克雷伯菌1株，检出率12．5％；ESBLs阳性菌株多重耐药现象较普遍，除耐β-内酰胺类抗菌药物外，耐妥布霉素、环丙沙星也相对较多；阿米卡星耐药率相对偏低，甚至对β-内酰胺酶抑制剂的复合抗菌剂也产生较高的耐药性。结论产ESBLs细菌在本地区广泛存在，已成为主要引起耐药的菌株，而且耐药谱广，多重耐药明显；加强对产ESBLs细菌感染的控制。加强对抗菌药物使用的监督与管理，是摆在我们面前的重要而迫切的任务。

OBJECTIVE To comprehend antimicrobial susceptibility distribution of the β-lactamases products from Feb 2002 to Feb 2003 in our hospital. METHODS The Microscan-USA was used to identify pathogens and drug sensitivity tests, the results of examination were judged according to NCCLS 1999 standard. RESULTS Among the isolated 67 strains of ESBLs-producing bacteria （35.64%）, 31 strains of Klebsiella pneumoniae （36.05%）, 29 strains of Escherichia coli （43.28%）, 6 strains of Enterobactercloacae （22.22%）and 1 of K. oxytoca （12.5%） were detected. The multi-resistance of ESBLs＋ bacteria was very usual, besides to the β-lactam antibiotics. The pattern of being resistant to both of tobramycin and ciprofloxacin was relatively common, and amikacin was relatively less, even the complex antibiotics containing β-lactamases inhibitor would lose their effect. CONCLUSIONSThe ESBLs bacteria exist in our area at a high level and also be the main antimicrobial-resistant ones and have got the resistance to many kinds of antibiotics. To control the ESBLs＋ bacteria infection, expanding and supervision management of antibiotics is a urged task and important for us.