大肠埃希氏菌和肺炎克雷伯菌AmpC酶及ESBLs酶的检测及耐药性分析

Detection of AmpC and extended spectrum β-lactamases in Escherichia coli and Klebslella pneumoniae and analysis of resistance

目的:了解我院大肠埃希菌和肺炎克雷伯菌产AmpC酶和产ESBLs的情况及耐药性分析,为临床合理用药提供依据。方法:分别采用改良三维试验和CLSI/NCCLS推荐的纸片扩散法确证试验,检测大肠埃希菌和肺炎克雷伯菌产AmpC酶和产ESBLs菌株。结果:大肠埃希菌和肺炎克雷伯菌单产AmpC酶菌株检出率分别为9.3%和4%,单产ESBLs检出率分别为28%和12%,同时产AmpC酶及ESBLs检出率分别为14.7%和0。两种菌单产AmpC酶和单产ESBLs的菌株以及同时产两种酶的菌株对亚胺培南保持较低耐药率,均低于15%,而对其它类抗菌素大于50%,耐药率均较高。两种菌产酶株与不产酶菌株耐药率相比,均有显著性差异(P<0.01)。结论:产酶株耐药情况严重,应慎重选择用药,减缓耐药菌株的进一步发生发展。

Objective： To investigate the production and resisranee of AmpC β- laetamases and extended spectrum β - laetmases（ESBLs） in Escherichia coli and Klebsldla pneumoniae in our hospital, Methods.A modified three diamensions extract test was used to detect AmpC and ESBLs were detected by the disk diffusion methed recommended by CLSI/NCCLS. Results：The producing rate of AmpC, ESBLs and AmpC＋ESBLs in Escherichia coli and Klebsldla pneumoniae was 9. 3%, 4%, 28%, 12%, 14. 7% and 0, respectively, and their resistance rates of enzyme - producing strains were lower than 15% against imipenen and higher than 50% against other antibiotics. Conclusion：The resistance of enzyme - producing strains was very severe. Therefore, the antibiotics should he used rationally to prevent spread of drug resistant bacteria.