产超广谱β-内酰酶细菌检测及耐药性分析

Detection of Bacteria Producing Extended-spectrum β-lactamase and an Analysis of Their Antibiotic Resistance

目的:了解产超广谱β-内酰酶(ESBLs)肺炎克雷伯菌和大肠埃希菌在我院的分离、分布情况、耐药特点,以便及时监控和治疗.方法:先用纸片扩散初筛法从140株肺炎克雷伯菌和大肠埃希菌中筛选出38株可疑产ESBLs菌株,再用纸片扩散确证法确认.结果:ESBLs总阳性率为27.1%,以重症监护病房为最高.产ESBLs菌对头孢他啶、头孢噻肟、头孢曲松的耐药率高达83.3%～96.2%,对亚胺培南全部敏感.结论:纸片扩散法是一种有效地检测ESBLs的方法,治疗ESBLs细菌所致感染,可应用亚胺培南、头霉素类、含β-内酰胺酶抑制复合物及药敏显示敏感的药物.

Objective: To investigate the distribution and their antibiotic resistance of strains of Klebsiellapneumoniae and Escherichia coli that produce extended-spectrum β-lactamase (ESBLs), for better controlling bacterial infections in our hospital. Methods: By a disk diffusion screening test, 38 strains of them were sus-pected of producing ESBLs from 140 strains of K. pneumoniae and E. coli isolates; furthermore these 38 strains were approved by a disk diffusion confirmatory test. Result: The prevalence of ESBLs in the isolates of K. pneumoniae and E. coli in our hospital was 27.1 %, the ICU being highest in all wards. The antibiotic resistance rate of ESBLs-producing strains of ceftozidime, cefotaxime, and ceftriaxone was 83. 3%-96. 2% ; however all the tested strains were susceptible to impenem. Conclusions: The disk diffusion test is an effec-tive method for detecting ESBLs. To control the bacterial infections caused by ESBLs-producting bacteria clinically, choices should be made to use antibiotics such as impenem, cephamycins, β-lactam/ β-lactamase in-hibitor mixtures, and others which are sensitive to these bacteria.