产超广谱β-内酰胺酶大肠埃希菌与肺炎克雷伯菌耐药性分析

Drug resistance of extended spectrum β-lactamase producing escherichia coliand klebsiella pneumoniae

目的了解铜仁地区产超广谱β-内酰胺酶(ESBLs)大肠埃希菌与肺炎克雷伯菌耐药性,为临床用药提供依据。方法双纸片协同试验及纸片扩散确证试验检测ESBLs,根据NCCLS 2005年判断标准分析结果。结果从790株阳性标本中检出产ESBLs菌株275株,总检出率为34.8%,其中大肠埃希菌产ESBLs 177株,肺炎克雷伯菌98株,检出率分别为22.4%和12.4%;产酶菌株对头孢菌素耐药率明显高于非产酶株,产ESBLs细菌对青霉素类和头孢类抗菌药物大多耐药,而对亚胺培南与美罗培南敏感性好。结论 ESBLs产酶株对多种抗菌药物耐药,仅对亚胺培南与美罗培南敏感,及时监测产ESBLs的发生率及其耐药趋势,指导临床用药至关重要。

OBJECTIVE To understand the drug resistance of extended spectrum β-lactamases producing Escherichia coli and Klebsiella pneumoniae in Tongren,to provide bases for clinical application of antibiotics.METHODS Double-disc synergy test and disk diffusion confirmatory test were used to detect extended-spectrum β-lactamases（ESBLs）,the results were analyzed according to NCCLs2005 year criterion.RESULTS A total of 275 ESBLs producing strains were detected from the 790 positive samples,the total detection rate was 34.8%,which ESBLs producing E.coli were 177 strains and K.pneumoniae 98 strains,and the detection rates were 22.4% and 12.4%,respectively.The drug resistant rate of enzyme producing strains to cephalosporin was significantly higher than that of non-enzyme producing strains,ESBLs producing bacteria were resistant to most of penicillins and cephalosporins antibiotics,but sensitive to imipenem and meropenem.CONCLUSION ESBLs producing strains are muti-drug resistant and only sensitive to imipenem and meropenem,to monitor the incidence of ESBLs producing strains and the drug resistance trends is essential to guide the clinical use of drugs.