腹腔与胆道分离大肠埃希菌产超广谱β-内酰胺酶菌株及其耐药性检测

Extended-spectrum β-Lactamases and Resistance in Escherichia coli Isolated from Biliary Tract and Abdominal Cavity

目的了解胆道与腹腔分离大肠埃希菌产超广谱β-内酰胺酶(ESBLs)菌株的发生率及其耐药性。方法CLSI表型确证试验(纸片增强法)检测产ESBLs菌株,琼脂稀释法进行药敏试验。结果47株胆道与腹腔分离大肠埃希菌中,产ESBLs菌株的发生率为50.1%;产ESBLs菌株对氨苄西林、第一、二代头孢菌素、氟喹诺酮类、头孢噻肟耐药显著,对头孢他啶、头孢吡肟、头孢哌酮/舒巴坦、阿米卡星、头孢美唑耐药率<40.0%,对美罗培南的耐药率为0;非产ESBLs菌株对氨苄西林、第一、二代头孢菌素、氟喹诺酮类耐药率较高,对其他抗菌药物均较为敏感;产ESBLs菌株对第一、二代头孢菌素、环丙沙星、头孢噻肟耐药率显著高于非产ESBLs菌株差异有统计学意义(P<0.05)。结论胆道与腹腔分离大肠埃希菌中产ESBLs菌株的发生率较高,产ESBLs菌株多药耐药显著,临床应加强检测和监测。

OBJECTIVE To investigate the prevalence of extended-spectrum β-lactamases （ESBLs） and the resistance in Escherichia coli isolates from biliary tract and abdominal cavity. METHODS ESBLs-producers were detected by CLSI Phenotypic Confirmatory Test and susceptibilities were tested by agar dilution method. RESULTS 50.1% Of isolates were ESBLs producers in those isolates. ESBLs producers were highly resistant to ampicillin, cefazolin, cefuroxime, fluoroquinolones, and cefotaxime. The resistant rate to ceftazidime, cefepime, cefoperazone-sulbactam, amikacin, and cefmetazole was less than 40%. None was resistant to meropenem in ESBLs producers. In non-ESBLs producers the resistant rate to ampicillin, cefazolin, cefuroxime, fluoroquinolones was more than 40% and most were susceptible to other antimicrobial agents. The resistant rate to ampicillin, cefazolin, cefuroxime, and ciprofloxacin was significantly higher in ESBLs producers than non- ESBLs producers. CONCLUSIONS With resistance to most of antimicrobial agents, ESBLs-producers were highly prevalent in E. coli isolates from biliary tract and abdominal cavity, so more attention should be paid to survey and detect those strains.