产超广谱β-内酰胺酶菌株在住院患儿中的分布及耐药性分析

Distribution and antibiotic resistance analysis of producing extended-spectrum β-lactamase producing strains in hospitalized children

目的探讨儿科住院患者产超广谱β-内酰胺酶(ESBLs)菌株的分布及耐药性情况。方法对深圳市妇幼保健院2008年至2011年儿科收治的住院患儿中ESBLs阳性菌感染情况进行回顾性分析,采用全自动细菌鉴定/药敏分析仪从标本中分离的大肠埃希菌和肺炎克雷伯杆菌进行检测。结果本组共检测出革兰阴性杆菌695株,共发现295株ESBLs阳性菌株,检出率为42.45%(295/695)。其中695株中大肠埃希菌230株,产ESBLs菌114株,占49.57%;肺炎克雷伯菌261株,产ESBLs菌181株,占69.35%。ESBLs阳性菌对不同抗生素耐药率及敏感率不同,差异有统计学意义(P<0.01,P<0.05)。结论 ES-BLs阳性菌已经成为儿科住院患儿中较为重要的耐药菌株,对抗菌药物的耐药性明显高于非产ESBLs菌,除亚胺培南外,产ESBLs菌对多种抗菌药物均出现不同程度的耐药性。对其治疗应依据药敏检测结果选择抗生素。

Objective To investigate the distribution of production of extended spectrum β-lactamases（ESBLs） in the pediatric inpatient strains and drug resistance.Methods ESBLs positive bacterial infections in hospitalized children admitted to hospital in 2008 to 2011,were analyzed retrospectively,using automatic bacterial identification / susceptibility analyzers isolated from Escherichia coli and Klebsiella pneumoniae Peter bacilli testing.Results A total of Gram-negative bacilli 695,a total of 295 ESBLs positive strains,the detection rate of 42.45%（295/695）.Escherichia coli 230 ESBLs-producing strains of 114,accounting for 49.57%;Klebsiella pneumoniae 261,181 ESBLs-producing strains,accounting for 69.35%.ESBLs positive bacteria different antibiotic resistance rate and sensitivity rate,the difference was statistically significant（P0.01,P0.05）.Conclusions ESBLs positive bacteria has become more important in the pediatric inpatient children with drug-resistant strains,resistance to antimicrobial drugs was significantly higher than non-ESBLs bacteria ESBLs producing bacteria to multiple antimicrobial agents,in addition to imipenem,varying degrees of resistance.Its choice of antibiotic therapy should be based on susceptibility testing results.