产超广谱β-内酰胺酶细菌耐药性分析

Analysis of extended-spectrum β-lactamases-producing bacterial resistance

目的研究临床肠杆菌科细菌产超广谱β-内酰胺酶(ESBLs)的发生率及耐药性,为临床抗感染治疗提供依据。方法采用美国临床实验室标准化研究所(CLSI)推荐的初筛试验和表型确证试验检测ESBLs阳性菌株。结果196株肠杆菌科细菌检出产ESBLs菌89株(45.4%);大肠埃希菌、肺炎克雷伯菌和变形杆菌在ESBLs阳性菌株中的构成比依次为46.1%、50.6%和1.1%,产酶率则分别为43.6%、51.1%和16.7%。89株产ESBLs菌的来源构成比为痰48.3%、尿29.2%、分泌物12.3%、血液7.9%。结论ESBLs的产生是肠杆菌科细菌对β-内酰胺类抗菌药物耐药的重要机制,临床实验室应加强检测,指导临床合理使用抗菌药物。

Objective To study the incidence and antibiotic resistance of ESBLs-producing clinical Enterobacteriaceae bacterium and to provide reliable evidence for clinical anti-infective therapy. Methods The positive ESBLs- producing strains were screened by initial screening test and confirmed by the phenotypic confirmatory test recommended by Clinical and Laboratory Standards Institute（CLSI）. Results The positive rate of ESBLs-producing Enterobacteriaceae bacteria strains was 45.4%;the proportion of Escherichia coli, Klebsiella pneumoniae, and Proteus in the ESBLs positive strains were 46. 1% ,50. 6% and 1.1% ,and enzyme production rates were 43.6% ,among 89 producing ESBLs strains of Enterobacteriaceae, sputum accounted for 48.3 %, urine aecounted for 29.2 %, secretion accounted for 12.3%,and blood accounted for 7. 9%. Conclusion The emergence of ESBLs producing is an important mechanism that Enterobacteriaceae bacteria resist β-lactam antibiotics. And clinical laboratory testing should be strengthened so as to guide the rational clinical drug application.