产酶的革兰阴性杆菌对抗生素的耐药性分析

Assay on Drug-Resistance of Gram-Negative Bacilli Producing Enzymes

目的:探讨G-杆菌的产酶情况与耐药模式,并比较产酶菌与非产酶菌对9种抗生素的耐药率。方法:应用头孢西丁三维试验检测AmpC酶,采用美国国家临床实验室标准委员会(NCCLS)表型筛选和确认试验检测超广谱酶β内酰胺酶(ESBLs)菌株,以K-B琼脂扩散法做药敏试验。结果:在149株G-杆菌中,16株(10.7%)产AmpC酶,32株(21.1%)产ESBLs,2株(2.0%)同时产AmpC酶和ESBLs。产酶株对亚胺培南、头孢吡肟、阿米卡星耐药率低。结论:产AmpC酶和产ESBLs的G-杆菌为多重耐药菌株,治疗产2种β内酰胺酶细菌引起的感染亚胺培南为首选,头孢吡肟和阿米卡星可作为选用药物之一。

Objective： To study the drug-resistance of gram-negative bacilli producing enzymes and compare the resistance rate of strains producing and non producing enzymes to 9 antibiotics.Method：A three-dimensional test of cefoxitin and E-test were used to detect AmpC enzyme and extended spectrum βlactamases（ESBLS） respectively.Simotanously,drug-susceptibility was meastured by disk diffusion method in 149 strains of gram-negative bacilli.Results：16（10.7%）strains were AmpC positive,32（21.1%）strains were ESBLS positive and 2（2.0%）strains AmpC＋ ESBLS were found among 149 strains of Gram negative bacilli.The resistance rate of strains-producing enzymes were low to imipenem,cepepime and amikacin.Conclusion：Gram-negative bacilli producing AmpC and ESBLS is multidrug-resistance strains.Imipenem is the most effective antibiotic for the treatment of infection caused by ESBLS or AmpC producing strains.Cepepime and amikacin are also effective for the treatment of such infections.