产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌的检测和耐药性分析

Detection of ESBLs produced by Escherichia coli and Klebsiella pneumonia and drug resistance monitoring

目的:了解富阳市中医院2003年1月至2008年6月间临床分离的大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)的情况,监测并分析大肠埃希菌和肺炎克雷伯菌的耐药特性,为临床合理使用抗菌药物提供依据。方法:采用API微生物鉴定系统进行鉴定;对分离的大肠埃希菌和肺炎克雷伯菌采用纸片扩散法进行药物敏感试验,用筛选和确证试验确认产ESBLs菌株,用WHONET5.3软件进行数据分析。结果:检出大肠埃希菌727株,产ESBLs大肠埃希菌162株,占22.3%,检出肺炎克雷伯菌465株,产ESBLs肺炎克雷伯菌122株,占26.2%。产ESBLs菌株的耐药性显著高于非产ESBLs菌株(P<0.05),产ESBLs菌株呈多重耐药。结论:产ESBLs菌株及其耐药性监测,可指导临床合理使用抗菌药物,减缓细菌耐药性的产生。

Objective： To investigate the status of extended - spectrum B - lactamases （ESBLs） production by Escherichia coli and Klebsiella pneumonia, analyze the characteristics of drug resistance of Escherichia coli and Klebsiella pneumonia in our hospital from Jan 2003 to June 2008,in order to provide a guidance to clinical rational use of antibiotics. Methods：The strains were identi- fied by API microbiological assay system. ESBLs - producing Disc diffusion test （ K - B method） was used to study the drug resist- ance of E. coli and K. pneumonia isolates, and ESBLs -producing strains were identified with screening test and confirmatory test. WHONETS. 3software was apllied to performing data analysis. Results： In 727strains of E. coli, 162 strains （ 22. 3% ） were detected to produce ESBLs ; in 465strains of K. pneumonia, 122 strains （ 26.2% ） were detected to produce ESBLs. The resistance rate of ESBLs - producing strains was significantly higher than that of ESBLs nonproducing ones （ P 〈 0. 05 ）, and but ESBIs - producing strains displayed multi - resistant. Conclusion： Monitoring of ESBLs producing strains and the drug - resistance can contribute to guide the clinically reasonable use of antibiotics.