产ESBLs细菌对哌拉西林／他唑巴坦的耐药性分析

Drug resistance of extended spectrum bata-lactamases-producing bacteria to piperacillin/tazobactam

目的了解哌拉西林/他唑巴坦对医院新生儿病房分离的产超广谱β-酰胺酶(ESBLs)细菌的体外抗菌活性,合理指导临床用药。方法使用Phoenix 100全自动微生物分析仪检测2007年1月-2010年12月新生儿病房患儿各类临床标本中分离的产ESBLs菌对哌拉西林/他唑巴坦的药物敏感性。结果共分离出产ESBLs菌135株,包括肺炎克雷伯菌83株,占61.5%,大肠埃希菌40株,占29.6%,奇异变形菌9株,占6.7%,阴沟肠杆菌3株,占2.2%;产ESBLs细菌对哌拉西林/他唑巴坦耐药率为12.6%,其中肺炎克雷伯菌和大肠埃希菌对哌拉西林/他唑巴坦耐药率分别为14.5%和12.5%;未出现奇异变形菌、阴沟肠杆菌对哌拉西林/他唑巴坦耐药株。结论新生儿病房检出产ESBLs细菌以肺炎雷伯菌和大肠埃希菌为主,哌拉西林/他唑巴坦对产ESBLs菌具有较强的抗菌活性,其中对大肠埃希菌的抗菌活性高于肺炎克雷伯菌。

OBJECTIVE To study the in vitro antibacterial activities of piperacillin/tazobactam against extended spectrum bata-lactamases-（ESBLs）producing bacteria of clinical isolates in neonatal ward, and provide evidence for clinical medication. METHODS The susceptibility of ESBLs-producing bacteria to piperacillin/tazobactam in neonatal ward from 2007 to 2010 was determined by Phoenix 100 full-automatic microbial system. RESULTS A total of 135 ESBLs-producing strains were detected, including 83 strains of Klebsiella pneumoniae with the detection rate of 61. 50/00, 40 strains of Escherichia coli with the detection rate of 29. 6~, 9 strains of Proteus mirabilis with positive rate of 6.7%, and 3 strains of Enterobacter cloacae with the detection rate of 2.2%. The resistance rates of ESBLs-producing bacteria to piperacillin/tazobactam were 12. 60/00. The resistant rates of K. pneurnoniae and E. coli were 14. 5% and 12. 5%, respectively. No strains of E. cloacae and P. mirabilis resistant to piperacillin/tazobactam were found. CONCLUSION K. pneumoniae and E. coli are the predominant ESBLs-producing bacteria in neonatal wards. Piperacillin/tazobactam has high antimicrobial activity against ESBLs producing bacteria. The in vitro antimicrobial activity of piperacillin/tazobactam against E. coli is higher than that against K. pneumoniae.