ESBLs阳性的肠杆菌科细菌医院感染流行趋势及耐药性观察

Observation on trend and drug-resistance of ESBLs positive bacteria in hospital infection

目的:观察分析ESBLs阳性的肠杆菌科细菌医院感染流行趋势及对常用17种抗菌药耐药性变迁。方法:利用双纸片协同试验及纸片法确认实验检测ESBLs阳性菌,并用纸片扩散试验和微量稀释法测定细菌对抗生素的敏感性。结果:ESBLs阳性的大肠埃希菌和肺炎克雷伯杆菌对青霉素、三及四代头孢菌素、复方新诺明、环丙沙星、庆大霉素均耐药;对阿米卡星、头孢西丁、添加酶抑制剂的抗生素较敏感;对亚胺培南无耐药。结论:产ESBLs是大肠埃希氏菌和肺炎克雷伯杆菌的主要耐药机制之一,使用以往常用的抗生素不再适合作为经验治疗的一线用药,可使用阿米卡星、头孢西丁、添加酶抑制剂合剂等抗生素,碳青霉烯类仍然是最敏感的药物。

Objective：To observe the trend and drug-resistance of ESBLs positive bacteria in hospital infection.Methods： ESBLs positive bacteria was identified by double paper method.The sensitivity of antibiotics was detected by paper spread test and micro-dilution assay.Results： ESBLs positive bacteria showed the drug-resistance to Penicillin G,the third and fourth generation of Ceftazidime,Compound Sulfamethoxazole tablets,Ciprofloxacin and Gentamicin,sensitive to Cmikacin,no drug-resistance to Peinon.Conclusion：For gut bacteria,the ESBLs production is one of the factors,which lead to produce the drug-resistance.The drugs,used in past time are not suitable to be the first line drugs because of the drug-resistance.Cmikacin and Peinon may be used to control the hospital infection caused by these bacteria.