几种产超广谱β-内酰胺酶细菌耐药性的动态分析

Antimicrobial resistance surveillance study among extend spectrum β-lactamase in different bacterial

目的对我院2008～2010年几种常见的产超广谱β-内酰胺酶(ESBL)细菌的检出、分布,耐药性等状况进行统计分析,为临床用药和控制感染提供依据。方法收集我院近三年来分离的非重复性的1331株肠杆菌科细菌,采用Vitek-2 Compact全自动细菌鉴定/药敏分析系统进行鉴定及药敏试验,采用WHONE5.5软件进行药敏结果分析。结果在分析的肠杆菌科细菌中,检测出产ESBL菌有513株(49.51%)。泌尿外科、呼吸内科、新生儿科、普通外科等科室分布靠前。呼吸道、尿液、分泌物等标本检出比例较大。近三年产ESBL菌株检出率均有不同程度的升高。药敏试验结果显示,产ESBL阳性菌株的敏感率明显低于ESBL阴性菌株。对ESBL阳性菌株而言,亚胺培南、哌拉西林/他唑巴坦、阿米卡星的敏感性较高;而对头孢菌素三代、喹诺酮类、氨苄西林/舒巴坦等敏感性较低。结论细菌耐药性在目前仍呈增长趋势,产ESBL细菌的耐药性增长尤为明显,加强耐药性的监测,对临床合理选用抗菌药有较积极的作用。

Objective To investigated the detection,distribution and resistance of the commonly extended spectrum beta-lactamase producing bacterium in our hospital in 2008~2010,and provide the fact for clinical application of antibiotics and infection control.Methods Acquire 1331 strains of pathogenic bacteria witch were isolated in our hospital in the last three years,Vitek-2 compact was used to analyze bacterial identification and susceptibility test,WHONET 5.5 statistic software was used to analyze the data.Results Among 1331 strains of pathogenic bacteria,513 strains were extended-spectrum beta-lactamase producing bacterium,accounted for 49.51%.Urology,Respiratory Medicine,Neonatology and General Surgery were on the top,samples mainly come from respiratory tract,genitourinary tract,purulent secretions.The detection of extended-spectrum beta-lactamase producing bacterium was increasing in the last three years.Susceptibility test results show that the positive strains of ESBL were much lower than the negative strains on drug sensitivity rate.Imipenem,Piperacillin/Tazobactam,Amikacin were high activity.Conclusion The drug resistance of bacterial is increasing currently,especially to extended-spectrum beta-lactamase producing bacterium.Strengthen surveillance of antimicrobial resistance have a positive effect on rational use of antibiotics.