革兰阴性杆菌高产AmpC酶的检测及耐药性分析

Detection of Hyperproduced AmpC β-Lactamases and Analysis of Its Resistance of Gram Negative Bacilli

目的:了解革兰阴性杆菌高产AmpC酶检出的情况及其对10种常用抗菌药物的耐药性分析。方法:对我院2001～2004年临床标本分离出的273株革兰阴性杆菌,用粗提酶头孢西丁三维试验检测高产AmpC酶并分析其对10种常用抗菌药物的耐药性。结果:273株革兰阴性杆菌中,高产AmpC酶菌株共74株,检出率为27.1%;除对亚胺培南、头孢吡肟耐药性较低外,它们对其他抗菌药物高度耐药,耐药率大多数高于80%;产AmpC酶菌株耐药性明显高于非产酶菌株。结论:高产AmpC酶的革兰阴性杆菌日益增多,耐药性强,临床治疗应首选碳青霉烯类抗生素和第四代头孢菌素。

Objective：To investigate the epidemiology of hyperproduced AmpC β-lactamases and the resistant to antibiotic in Gram negative bacilli. Methods： Hperproduced AmpC β-lactamases were detected by enzyme extraction three dimensional and their resistance to antibiotic in 273 strains Gram negative bacilli isolated from clincial samples in our hospital during 2001 to 2004. Results ： 74 of 273 strains were producing the hyperproduced AmpC β-lactamases and the positive rate was 27.1%. In 10 antibiotic, the Gram negative bacilli producing the hyperproduced AmpC β-lactamases were multidrug resistant,enzyme positive strains were more resistant to antibiotics than negative ones. Conclusions： More and more hyperproduced AmpC β-lactamases is continuously produced in Gram negative bacilli,and drug resistance rate is thus increasing. Imipeneum and the fourth cephalosporin should be the first choice in clinical threatment.