县级医院大肠埃希菌与克雷伯菌属的耐药性监测

Surveillance to drug resistance of escherichia coli and klebsiella in county hospitals

目的探讨县级医院临床分离的大肠埃希菌和克雷伯菌属对常用抗菌药物的耐药性,为临床医师合理使用抗菌药物提供依据。方法采用CLSI推荐的K-B法进行抗菌药物敏感试验,采用CLSI推荐的双纸片协同试验和确证试验检测细菌ESBLs。结果医院分离的138株大肠埃希菌,产ESBLs率为65.2%;44株克雷伯菌属,产ESBLs率为54.5%,耐药表型结果显示,产ESBLs菌对15种抗菌药物的耐药性已十分严重。结论产ESBLs是肠杆菌科细菌对β-内酰胺类抗菌药物耐药的重要机制,应引起高度关注。

OBJECTIVE To investigate the drug resistance of commonly used antibiotics in clinical isolates of Escherichia coli（E.coli） and Klebsiella in county hospital in order to provide references for the clinical application of antibiotics.METHODS The bacterial susceptibility testing was performed by K-B method recommended by CLSI.ESBLs were detected by double disks synergy test and disk confirmatory test.RESULTS Of 138 E.coli,65.2% were ESBLs producing.Of 44 Klebsiella,54.5% were ESBLs producers.The bacterial susceptibility testing results showed that the drug resistance of 15 antibiotics in ESBLs producers were very serious.CONCLUSION The ESBLs-producing is the most important resistant mechanism of Enterobacteriaceae to β-lactam antibiotics.Therefore,it should be highly attached importance.