产超广谱β-内酰胺酶细菌的检测及耐药性分析

Examination and Resistance Analysis of Producing Extended-spectrum β-lactamase Strains

目的:了解本院近三年产ESBLs大肠埃希菌的耐药性,指导临床合理使用抗菌药物。方法:采取前瞻性监测的方法对我院2008年至2011年临床分离出的1120株产ESBLs的大肠埃希菌进行监测,对药敏结果进行分析。结果:发现近三年来产ESBLs的大肠埃希菌的检出率分别是51.7%、52.7%和55.6%;药敏试验发现,ESBLs对头孢呋辛、头孢曲松等第3代头孢菌素及单环β-酰胺类抗菌药物有较高的耐药性,而对氨基糖苷类、氟喹诺酮类、磺胺类抗菌药物也有较高耐药性,但是对亚胺培南+西司他丁(也就是泰能,因为亚胺培南单用是不稳定的,临床一般不单独用)敏感。结论:研究发现,近年来产超广谱β-内酰胺酶的大肠埃希菌检出率逐年增高并且具有多重耐药性的特点,需引起临床的高度重视,从而指导临床合理应用抗菌药物、控制ESBLs菌株的进一步传播和流行。

Objective： To understand the resistance of ESBL strains of our hospital in recent three years and then guide the rational use of antibacterial drugs clinically.Method： Adopted the method of prospective monitoring to study 1120 strains of escherichia coli of producing extended-spectrum β-lactamase clinically separated from 2008 to 2011 in our hospital,and analyzed results of drug sensitivity.Result： The detection rate of escherichia coli of producing extended-spectrum β-lactamase in recent years was 51.7%,52.7% and 55.6% respectively.According to the drug sensitivity test,there were high resistance of ESBLs to the 3rd generation of cephalosporins of cefuroxime and ceftriaxone and monocyclic β-lactams,as well as aminoglycosides,flouroquinolones and sulfonamides,while sensitive to imipenem-cilastatin（namely Taineng,because the single usage of imipenem is instable）.Conclusion： Results indicate that the detection rate of escherichia coli of producing extended-spectrum β-lactamase increases year by year and there are multi-drug resistance.Clinicians should pay a high attention to it and guide the clinical rational usage of antibacterial drugs and thus control the further transmission and prevalence of ESBL strains.