产ESBLs大肠埃希菌和肺炎克雷伯菌的耐药性分析

Drug resistance analysis on E.coli and K.pneumoniae produced extended spectrum β-lactamases

目的了解我院2009年1～12月大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)菌株的分布情况及耐药性,指导临床用药。方法采用纸片扩散法(K-B法)和酶抑制剂增强纸片扩散法对396株大肠埃希菌和肺炎克雷伯菌进行检测和分析。结果大肠埃希菌和肺炎克雷伯菌ESBLs的检出率分别为52.7%和35.7%,产ESBLs菌对亚胺培南、哌拉西林/舒巴坦、头孢西丁和阿米卡星的耐药率较低。结论重视产ESBLs菌的检测,应根据药敏试验合理用药,碳青霉烯类、头孢西丁及β-内酰胺酶抑制剂复合物、阿米卡星是目前治疗产ESBLs菌比较理想的抗菌药物。

Objective To investigate the resistance and distributing situation of extended-spectrum β-lactamases （ESBLs）-producing strains in E.coli and K.pneumoniae in our hospital during last year,so as to guide the clinical drug use.Methods 396 strains of E.coli and K.pneumoniae were detected and analyzed by K-B agar diffusion method and confirmed test.Results The positive rate of ESBLs-producing among E.coli and K.pneumoniae was 52.7% and 35.7%,respectively. ESBLs had lower drug resistant rate to imipenem,piperacillin/sulbactam,cefoxitin and amikacin.Conclusion It is very important to pay attention to the determination of ESBLs-producing strains.We should reasonably use drug according to the result of susceptibility test.The ideal antibacterial drugs for treating ESBLs-producing bacteria are carbapenems,cefoxitin,complex antibiotics containing β-lactamases inhibitor and amikacin.