三种方法检测大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶的研究

Study on the production of extended spectrum β lactamases among E.coli and K.pneumoniae.

目的 :用纸片协同试验、纸片确证试验和克拉维酸纸片叠加法检测产 ESBL s的大肠埃希菌和肺炎克雷伯菌 ,并调查了医院感染这两种菌产 ESBL s的流行现状。方法 :采用头孢他啶、头孢曲松、头孢噻肟和氨曲南为底物 ,用上述三种试验对临床分离的 99株大肠埃希菌和 48株肺炎克雷伯菌检测 ESBL s的产生。结果 :纸片确证试验和克拉维酸纸片叠加法检测结果没有显著差异 ,总检出率在大肠埃希菌中为 35 .4% ,在肺炎克雷伯菌中为43.8%。其中以头孢噻肟和头孢曲松为底物效果较好。结论 :克拉维酸纸片叠加试验是一种方便 ,敏感性和准确性较好的试验 。

For Detecting extended spectrum β lactamase(ESBL) in E.coli and K.pneumoniae with clavulanic acid additional test,and determining the prevalence in nosocomial infections of the two strains producing ESBLs, ceftazidime,cefotaxime,ceftriaxone and aztreonem were used as indicators.ESBLs production among 99 clinical isolates of E.coli and 48 isolates of K.pneumoniae was evaluated by the double disk synergy test,the confirmatory test and the clavulanic acid additional test.The results of the confirmatory test and the clavulanic acid additional test showed no obvious difference.The total detection rate was 35 4% in E.coli and 43 8% in K.pneumoniae.Cefotaxime and ceftriaxone were considered to be better indicators.The clavulanic acid additional test was more convenient,accurate and sensitive.The test was suitable for routine screening in clinical laboratory.