两种常见产超广谱β-内酰胺酶菌的检测及临床应用

Detection and Clinical Significance of Two Bacteria with ESBLs

目的:筛选检测肺炎克雷伯氏菌及大肠杆菌的超广谱的β-内酰胺酶(ESBLs)的敏感方法,并探讨肺炎克雷伯氏菌及大肠杆菌产ESBLs的情况与耐药的关系,为临床合理使用抗生素提供实验依据。方法:临床分离的78份菌株分别用4种方法进行ESBLs及耐药性的检测,比较其检出率及差异性。结果:单纸片加克拉维酸扩散法敏感性最好。肺炎克雷伯氏菌、大肠杆菌产ESBLs的阳性率在我院明显高出许多文献报道。结论:在仪器自动鉴定时,若ESBLs阳性的标本,应采取纸片法重新检测。我院肺炎克雷伯氏菌、大肠杆菌产ESBLs的阳性率应引起医务人员的重视,临床应加强监测,依据药敏情况合理选用抗生素。

Objective To screening sensitive test to detesting on ESBLs ot Klebsiella pneumonia（KL, pneumonia ）and E scherichia（E, coil）, study relation between ESBLs and resistance to antibiotics of KL. pneumonia and E. coli,provide suggestions empirical treatment against the bacteria. Methods 78 strains of KL pneumonia and E. coil were analyzed for ESBLs-producing and antibacterial susceptibility test by four means respectively, compared their positive rate dofference, Results single-disc diffusion method with clavulanic acidmost sensitive, positive rate of KL. pneumonia and E. coil in my hospital are higher than others reports. Conclusions when strains were examine produce ESBLs byautomatic bacterial identification analyzer,they should be confirm by single-disc test. positive rate of ESBLs-pruducing KL. pneumonia and E. coli were so high at our hospital, we should be pay moreattention to monitoring and the antibiotics should be rationally administrated according to drug sensitivity.