铜陵地区大肠埃希菌和克雷伯菌属ESBLs检测及耐药性分析

Detection of extended-spectrum beta-lactamases and resistance in Escherichia coli and Klebsiella isolates in Tongling area

目的了解安徽省铜陵地区大肠埃希菌和克雷伯菌属产ESBLs的检出率及其耐药状况。方法铜陵地区2003年1月-2004年12月临床分离大肠埃希菌270株和克雷伯菌属127株用NCCLS表型确证试验(纸片增强法)检测其ESBLs产生率;并用Kirby-Bauer法进行药敏试验。结果大肠埃希菌和克雷伯菌属ESBLs产生率分别为37.8%和30.7%;产ESBLs株对亚胺培南均呈敏感,对头孢西丁、头孢哌酮-舒巴坦及哌拉西林-三唑巴坦耐药率较低,对其他抗菌药物的耐药率均较不产ESBLs株高。结论临床上应加强细菌耐药性监测及ESBLs检测,指导临床合理使用抗菌药物,防止产ESBLs菌株的产生和流行。

Objective To investigate the resistance and extended-spectrum β-lactamases （ESBLs） in E. coli and Klebsiella isolates, which were isolated from January 2003 to December 2004 in Tongling area. Methods ESBLs production was detected by NCCLS phenotypic confirmatory test in E. coli （n = 270） and Klebsiella （n = 127） isolates. Antimicrobial susceptibility was tested by Kirby-Bauer method. Results The prevalence of ESBLs was 37.8% in E. coli and 30.7% in Klebsiella isolates. All ESBLs producing strains in our study were susceptible to imipenem, and relatively susceptible to cefoxitin, cefoperazone-sulbactam and piperacillin-tazobactam. ESBLs-producers had much higher resistance rates to other antimicrobial agents compared with ESBLs non-producing strains. Conclusions Surveillance of resistance and ESBLs detection are of great importance to both rational use of antibiotics and control of ESBL producers.