微生物检验中革兰氏阴性杆菌超广谱β-内酰胺酶检测结果分析

Analysis on gram-negative bacteria extended spectrumβ-lactamases in microbiological examination

目的通过对骨创伤患者分泌物所分离的克雷伯菌属、大肠埃希菌和其他肠杆菌科超广谱β-内酰胺酶(ESBLs)的临床微生物检验,研究该酶介导的耐药性能及其在临床上的应用。方法收集骨创伤患者分泌物分离的耐氨苄西林的克雷伯菌属、大肠埃希菌40株,以NCCLs推荐的初筛,Etest法操作,表型确证试验。结果其中有14株即35%的细菌被确认产出ESBLs,其中9株确认试验与Etest均阳性,产ESBLs的克雷伯菌属检出率为50%,大肠埃希菌的检出率为30.4%,其他肠杆菌科细菌检出率为33.3%。结论大肠埃希菌、肺炎克雷伯菌属于产出超广谱β-内酰胺酶的重要菌株,但是其他肠杆菌科细菌的检出率也在上升,尤其是不能忽略检测阴沟杆菌。头孢噻肟(CTX)是本地区超广潜β-内酰胺酶筛选的最佳底物。

Objective Bone trauma patients secretion of isolated Klebsiella, Escherichia coli and other Enterobacteriaceae, extended spectrum β- lactamases （ESBLs） in clinical microbiological testing of enzyme - mediated resistance medicine and its use in clinical applications. Methods The secretion of bone trauma patients resistant to ampicillin isolated Klebsiella pneumoniae, Escherichia coli forty to NCCLs recommended screening, Etest method is, phenotypic confirmatory test. Results One of fourteen or 35 % of the bacteria identified output ESBLs, of which nine were confirmed positive test and Etest, producing ESBLs in the detection rate of 50% of Klebsiella spp, Escherichia coli detection rate was 30. 4%, and other Enterebaectriaceae detection rate of 33.3%. Conclusion Escherichia cob and Klebsiella pneumoniae are output extended spectrum β-lactamase important strains, but other Enterobacteriaceae are also increasing the detection rate, especially can not ignore the detection of Enterobacter cloacae. Cefotaxime （CTX） is the region extended spectrum β-actamase screening of the best substrate.