产超广谱β-内酰胺酶大肠埃希菌与肺炎克雷伯菌的耐药性分析

Drug Resistance Analysis of Extended-spectrum β-Lactamases Producing Escherichia coli and Klebsiella pneumoniae

目的了解产超广谱β-内酰胺酶(ESBLs)大肠埃希菌与肺炎克雷伯菌的耐药性,为临床合理使用抗菌药物提供依据。方法采用美国德灵Microscan WalkAway40 S1自动微生物分析仪(W/A40)及专用NC21鉴定药敏复合板检测产超广谱β-内酰胺酶和药敏试验。结果 341株菌中共检测出ESBLs细菌150株,检出率43.99%,其中大肠埃希菌118株,检出率49.79%,肺炎克雷伯菌32株,检出率30.77%,产ESBLs菌株对大部分抗菌药物耐药,对亚胺培南、哌拉西林/他唑巴坦、阿米卡星、头孢西丁耐药性较低。结论及时监测产ESBLs菌的发生率及其耐药趋势,指导临床合理用药,亚胺培南、哌拉西林/他唑巴坦、阿米卡星、头孢西丁是目前治疗产ESBLs菌感染的有效抗菌药物。

OBJECTIVE To investigate the drug resistance of extended-spectrum β-lactamases（ESBLs） producing Escherichia coli and Klebsiella pneumoniae,providing evidence for the clinical rational administration of antimicrobial drugs.METHODS Using Microscan WalkAway40 S1 system and special plate NC21,ESBLs-producing E.coli and K.pneumoniae were detected from clinic specimens and drug sensitivity tests were carried out.RESULTS Among 341 isolates,150 strains（43.99%） were isolated producing ESBLs,with 49.79%（118/237） of E.coli and 30.77%（32/104） of K.pneumoniae.ESBLs-producing bacteria showed high resistance to a great number of antimicrobial drugs,and relatively low resistance to imipenem,piperacillin/tazobactam,amikacin and cefoxitin.CONCLUSIONS Detection of ESBLs prodution and susceptibility to antibiotics,in time can provide guidance to rational clinical administration of drugs.The imipenem,piperacillin/tazobactam,amikacin and cefoxitin could be effectively used in treatment of ESBLs-producing bacteria infectioons cases.